EP0904796A2 - Omni-directional steerable catheter - Google Patents

Omni-directional steerable catheter Download PDF

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Publication number
EP0904796A2
EP0904796A2 EP98307161A EP98307161A EP0904796A2 EP 0904796 A2 EP0904796 A2 EP 0904796A2 EP 98307161 A EP98307161 A EP 98307161A EP 98307161 A EP98307161 A EP 98307161A EP 0904796 A2 EP0904796 A2 EP 0904796A2
Authority
EP
European Patent Office
Prior art keywords
catheter
catheter body
tip section
lumen
puller wire
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP98307161A
Other languages
German (de)
French (fr)
Other versions
EP0904796B1 (en
EP0904796A3 (en
Inventor
Wilton W. Webster Jr.
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biosense Webster Inc
Original Assignee
Cordis Webster Inc
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Filing date
Publication date
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Publication of EP0904796A2 publication Critical patent/EP0904796A2/en
Publication of EP0904796A3 publication Critical patent/EP0904796A3/en
Application granted granted Critical
Publication of EP0904796B1 publication Critical patent/EP0904796B1/en
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Expired - Lifetime legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0147Tip steering devices with movable mechanical means, e.g. pull wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/01Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
    • A61B5/015By temperature mapping of body part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0136Handles therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0147Tip steering devices with movable mechanical means, e.g. pull wires
    • A61M2025/015Details of the distal fixation of the movable mechanical means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M2025/0161Tip steering devices wherein the distal tips have two or more deflection regions

Definitions

  • This invention relates to catheters having steerable tips and particularly to a catheter having a tip which is steerable in multiple directions.
  • Steerable or deflectable tip cardiovascular catheters are useful in many applications, being a marked improvement over catheters with fixed tip curves. They are especially useful in the field of electrophysiology for performing radio frequency ablation of abnormal electrical pathways in the heart.
  • steerable tip catheters There are presently several useful designs of steerable tip catheters.
  • One such steerable tip catheter is described in Reissue Patent No. 34,502.
  • the catheter has an elongated catheter body and tip portion which can be deflected into a semi-circle in one direction.
  • the catheter body and tip portion can be rotated. Therefore by tip deflection, catheter rotation and catheter translation, i.e., lengthwise movement of the catheter, contact of the tip portion with most areas of a heart chamber may be made.
  • One early multidirectional deflectable tip catheter had a catheter body and tip with 5 lumens, i.e., a central lumen and four outer lumens disposed symmetrically around the central lumen.
  • This catheter had four puller wires which extended through the outer lumens. The distal ends of the puller wires were attached to a ring at the tip and the proximal ends were attached to a "joy stick".
  • the central lumen was open at its distal end and connected to a luer hub at its proximal end.
  • This catheter had no reinforcement in its body or tip. It was not suitable for electrophysiology because it had effectively no torque transmission to the tip which made tip rotation difficult.
  • the catheter body was subject to the same deflection as the tip, but to a lesser degree.
  • a more recent steerable catheter has a steerable tip that is controlled by a bendable control handle. Multiple puller wires connect the steerable tip to this control handle which can be bent in any direction and can be thought of as a multiple ball joint with friction. The tip, once deflected, can be further deflected laterally by an internal stylette.
  • the disadvantage of this catheter design is that the tip is very soft and has poor lateral stiffness due to the presence of the stylette which cannot transmit torque effectively. Because of this, an electrode at the tip of the catheter cannot be held firmly against the myocardial wall.
  • Another recent steerable tip catheter comprises a deflectable tip which can be deflected in one direction by a puller wire and further deflected laterally by an internal stylette.
  • the stylette can also be moved axially within the catheter to change the shape of the tip curvature.
  • the disadvantage of this catheter design is that the lateral stiffness of the tip is dependent upon the stylette which cannot transmit torque effectively.
  • the tip In a design wherein the tip is rotated by means of a stylette, it follows that the lateral stiffness of the tip must be less than that of the stylette alone. This is because some torque from the stylette is required to rotate the tip. Moreover, the stylet must be kept small to allow the catheter body and tip to bend and to be safe within the patient body and heart.
  • the present invention provides a cardiovascular catheter comprising a steerable catheter tip section, an elongated catheter body and a control handle.
  • the catheter tip section comprises at least two and preferably four off-axis lumens.
  • the catheter body comprises at least one lumen in communication with the off-axis lumens of the catheter tip section.
  • the catheter body comprises a single lumen in communication with four off-axis lumens in the catheter tip section.
  • the catheter body comprise separate off-axis lumen aligned with each off-axis lumen of the catheter tip section.
  • the control handle which is attached to the proximal end of the catheter body, comprises a separate movable, preferably slidable, member associated with each of the off-axis lumens of the catheter tip section.
  • An elongated puller wire is connected at its proximal end to each of the movable members of the control handle.
  • Each puller wire extends through a lumen of the catheter body into the off-axis lumen in the catheter tip section and is anchored at its distal end to the wall of the catheter tip section or to a tip electrode. Movement of a movable member in the control handle results in movement of the puller wire connected to that movable member in a proximal direction relative to the catheter body and deflection of the tip section in the direction of the moved puller wire.
  • the movable members are slidable within the control handle.
  • An elongated puller wire is attached at the proximal end to each of the slidable members in the control handle.
  • Each puller wire extends through a lumen in the catheter body into an off axis lumen in the catheter tip section and is anchored either in the lumen wall or in a tip electrode. Proximal movement of a slidable member results in proximal movement of its puller wire relative to the catheter body and deflection of the catheter tip in that off axis direction.
  • Means are preferably provided for resisting compression forces on the catheter body when a puller wire is moved in a proximal direction relative to the catheter body.
  • Preferred means comprise a compression coil which extends through the catheter body in surrounding relation to each puller wire.
  • the proximal end of the compression coil is fixedly attached to the proximal end of the catheter body and the distal end of the compression coil is fixedly attached to the distal end of the catheter body and/or at a selected location along the length of the catheter tip section.
  • the site of the distal attachment of the compression coil and the anchor site of the puller wire associated with that compression coil in the tip section determine the length of the tip deflection curvature in the direction of that puller wire.
  • the catheter body and tip section contain four lumens arranged symmetrically in quadrants through which four puller wires extend.
  • Each puller wire extends through a separate lumen from the control handle through the catheter body to an anchor site in the tip section.
  • each lumen contains a compression coil in surrounding relation to the puller wire for resisting the compressive force of the puller wire, thereby preventing deflection of the catheter body.
  • the compression coil is fixedly attached to the proximal end of the catheter body and also near the transition of the catheter body to the tip section.
  • the puller wires are separated into first and second pairs, each pair containing diametrically opposed puller wires.
  • the anchor sites of the first pair of puller wires in the tip section are more proximal to the distal end of the tip section than the anchor sites of the second pair.
  • proximal movement of a puller wire from the first pair results in a first curve of the proximal portion of the catheter tip in the direction of the quadrant of that puller wire generally in a plane containing the axis of the catheter body.
  • proximal movement of an adjacent puller wire of the second pair results in a second, more distal curve in the direction of that adjacent puller wire quadrant in a plane generally transverse to the axis of the catheter body.
  • Such a compound curve is particularly useful in reaching around obstructions such as a papillary muscle or chorda within the heart.
  • a fifth lumen located central to the four quadrant lumens.
  • the fifth lumen runs the full length of the catheter body and tip section, or the full length of the tip section alone in a preferred embodiment.
  • the fifth lumen may serve to carry the electrode lead wires.
  • the fifth lumen may be open at its distal end to conduct fluids into or out of the vascular system. It may also serve to conduct other energy delivery devices such as an optical fiber, to carry a fiber optic bundle for direct viewing, to inflate a balloon, to serve as a conduit for needles and the like or other useful interventions.
  • the catheter body has a single central lumen into which the four puller wires and the lead wires from the five lumen tip converge and travel the full length of the body into the control handle.
  • the compression coils may be retained or omitted.
  • compression coils are included and the proximal ends of each of two diametrically opposed pairs of compression coils are fixedly anached to the proximal end of the catheter body.
  • the distal ends of the compression coils are fixedly attached to the distal end of the catheter body and/or at a selected location along the length of the catheter tip section.
  • one diametrically opposed pair of compression coils extends into the catheter tip and the other pair is fixedly attached to the distal end of the catheter body
  • the pair of compression coils extending into the tip is fixedly attached at a location on the tip section where the distal end of the puller wires of the other opposed pair of compression coils are fixedly attached.
  • a preferred control handle comprises a handle body having four movable, or slidable, members. Each slidable member is connected to a puller wire so that movement, preferably proximal movement, of a slidable member from a first position towards a second position results in proximal movement of the puller wire associated with that member with respect to the catheter body and deflection of the tip section in the direction of that puller wire quadrant.
  • means are provided to prevent simultaneous proximal movement of diametrically opposed buttons.
  • FIGS. 1 - 10 A particularly preferred deflectable electrode catheter constructed in accordance with the present invention as shown in FIGS. 1 - 10.
  • the catheter 10 comprises an elongated catheter body 12, a deflectable tip section 13 and a control handle 14.
  • the tip section 13 carries a plurality of electrodes 28 and 29.
  • the overall length and diameter of the catheter may vary according to the application.
  • a presently preferred catheter has an overall length of about 48 inches and an outer diameter of about 0.09 inches.
  • the catheter body 12 comprises an elongated tubular construction having four outer lumens 17 and a central lumen 18.
  • the outer lumens 17 are arranged symmetrically into quadrants about the central lumen 18.
  • the diameter of the lumens may vary as desired. In a preferred embodiment, each of the lumens has a diameter of about 0.018 inch.
  • the catheter body 12 is made of any suitable non-toxic material such as polyurethane.
  • the catheter body 12 is preferably reinforced with at least one layer of a braided mesh 15 of stainless steel or the like to increase its torsional stiffness.
  • the catheter tip section 13 comprises a short section of flexible tubing 21 having a central lumen 22 and four outer lumens 23 positioned symmetrically about the central lumen 22 as in the catheter body 12.
  • the tubing 21 is made of a suitable material and is preferably more flexible than the catheter body 12.
  • a presently preferred material for the catheter tip section 13 is polyurethane.
  • the catheter tip section 13 is preferably reinforced with a metallic braided mesh 24 similar to that on the catheter body 12 to impart the same high torque characteristics without appreciably increasing its bending stiffness.
  • the diameter of the catheter tip section 13 is preferably the same as or slightly smaller than that of the catheter body 12. In a preferred embodiment, the diameter of the catheter tip section is about 0.08-0.09 inches and the length is about 3 inches.
  • FIG. 3 A preferred means for attaching the catheter tip section 13 to the catheter body 12 is illustrated in FIG. 3.
  • the proximal end of the catheter tip section 13 comprises an outer circumferential notch 26 and the distal end of the catheter body 12 comprises an inner circumferential notch 27.
  • the notches 26 and 27 are sized such that the proximal end of the catheter tip section 13 fits snugly into the distal end of the catheter body 12.
  • the catheter tip section 13 is then fixedly attached to the catheter body by polyurethane glue or the like, creating a seam on the outer surface of the catheter at the junction between the catheter tip section 13 and the catheter body 12.
  • the central lumen 22 and outer lumens 23 of the catheter tip section 13 are aligned with and communicate with the central lumen 18 and outer lumens 17 of the catheter body 12 respectively.
  • a plurality of ring electrodes 28 are a plurality of ring electrodes 28.
  • the length of the electrodes 28 is not critical but is preferably about one to four millimeters.
  • the electrodes 28 are spaced apart a distance of about 2 to 4 millimeters.
  • a tip electrode 29 is at the distal end of the tip section 13.
  • Each electrode 28 and 29 is connected to a separate lead wire 36 which extends through the central lumens 18 and 22.
  • lead wires 36 are connected to an appropriate jack or other connector which can be plugged into or otherwise connected to a suitable monitor.
  • Each ring electrode 28 has an associated lead wire 36 which extends through the wall of the tip section to the electrode. Connection of the lead wires 36 to the electrode 28 is accomplished, for example, by first making a small hole through the wall of the catheter tip section 13 and into the central lumen 22. Such a hole may be created, for example, by inserting a needle through the tip section wall and heating the needle sufficiently to form a permanent hole. A lead wire 36 is then drawn through the hole by using a microhook or the like. The ends of the lead wire 36 are then stripped of any coating and soldered or welded to the underside of the electrode 28 which is then slid into position over the hole and fixed in place with polyurethane glue or the like.
  • a puller wire 31 extends from the control handle 14 through each of the outer lumens 17 in the catheter body 12 and into aligned outer lumen 23 of the tip section 13.
  • the puller wire 31 is made of any suitable metal such as stainless steel or Nitinol and is coated with Teflon®, Kevlor, carbon fiber or the like.
  • the puller wire has a diameter preferably from about 0.006 to about 0.010 inch.
  • a compression coil 33 extending through each outer lumen 17 in surrounding relation to each puller wire 31.
  • the compression coil 33 is made of a suitable metal, e.g., stainless steel, which is tightly wound on itself to provide flexibility, i.e., bending, but to resist compression.
  • the inner diameter of the compression coil 33 is selected to be slightly larger than the diameter of the puller wire 31. For example, when the puller wire 31 has a diameter of about 0.007 inch, a compression coil 33 having an inner diameter of about 0.008 inch is presently preferred.
  • the outer diameter of the compression coil 33 is likewise slightly smaller than the diameter of the lumen 17 through which it extends. For example, if the outer lumen 17 has a diameter of about 0.018 inch, the compression coil 33 preferably has an outer diameter of about 0.017 inch.
  • the compression coil 33 is fixedly attached to the proximal and distal ends of the catheter body 12 by polyurethane glue or the like.
  • the glue may be applied through a syringe or the like to the outer circumference of the ends of the compression coil 33, for example as shown in FIG. 3 as location A. Glue applied to this location wicks inwardly between the compression coil 33 and the wall forming the lumen 17. Upon curing, the glue joint 34 is formed.
  • the glue may be applied by means of a syringe or the like through a hole between the outer surface of the catheter body 12 and the lumen 17. Such a hole may be formed for example by a needle or the like which punctures the catheter body wall and is heated sufficiently to form a permanent hole.
  • the glue is introduced through the hole to the outer surface of the compression coil 33 and wicks around the outer circumference to form a glue joint 34 about the entire circumference of the compression coil 33.
  • each puller wire 31 is preferably coated with a very thin coating of Teflon®. This coating imparts lubricity to the puller wire 31 within the compression coil 33.
  • Each puller wire 31 is anchored to the side of the catheter tip section 13 or to a tip electrode.
  • the Teflon® sheath 32 prevents the puller wire from cutting into the wall of the tip section 13 when the tip section 13 is deflected.
  • the puller wire 31 extends beyond the Teflon® sheath 32.
  • the Teflon® coating on the puller wire 31 may also be removed at the distal end of the puller wire 31 or left on under the anchor 35.
  • An anchor 35 is fixedly attached to the distal end of the puller wire 31.
  • the anchor is formed by a metal tube 37, e.g., a short segment of hypodermic stock.
  • the tube 37 has a section which extends a short distance beyond the distal end of the puller wire 31.
  • a cross-piece 38 made of a small section of stainless steel ribbon or the like is soldered or welded in a transverse arrangement to the distal end of the tube section 37 which is flattened during the operation. This creates a T-bar anchor 35.
  • a notch 39 is created in the side of the catheter tip section 13 resulting in an opening into the outer lumen 23.
  • the anchor 35 lies particularly within the notch 39. Because the length of the ribbon forming the cross-piece 38 is longer than the diameter of the opening into the lumen 23, the anchor cannot be pulled completely into the lumen 23.
  • the notch 39 is then sealed with polyurethane 40 or the like to give a smooth outer surface.
  • the puller wires 31 are divided into two pairs, a first pair being anchored proximal to the anchor location of the second pair.
  • the second pair is anchored to the wall of the tip section 13 adjacent the distal end of tip section 13 or to a tip electrode.
  • the first pair of puller wires 31 are anchored to the wall of the tip section at a location spaced apart proximally from the anchor sites of the second pair.
  • the first pair may be anchored to the side wall of the tip section 13 as described above or, alternatively, may be anchored at the distal end of the tip section 13 as shown in FIG. 6A.
  • the puller wire 31 extends to the distal end of the outer lumen with the anchor, which is attached to the end of the puller wire, lying beyond the end of the lumen 23.
  • the anchor 35 is fixed in this position by a polyurethane cap 41 which also seals the distal end of the catheter tip section 13. Because the cross-piece is longer than the diameter of the lumen 23 the anchor 35 cannot be pulled back into the lumen when the tip section 13 is deflected.
  • This alternative anchoring method is useful when there is no tip electrode 29. If a tip electrode 29 is present, the puller wires 31 may be anchored to the side wall of the tip section 13 or to the tip electrode 29, e.g., by solder, as shown in FIG. 6B.
  • the distance between the distal end of the compression coil 33 and the anchor sites of the puller wire 31 in the tip section 13 determines the curvature of the tip section 13 in the direction of that puller wire 31.
  • the arrangement of the anchor sites of the puller wires 31 described above i.e., two diametrically opposed pairs anchored at different distances from the distal end of the compression coil 33, allows a long reach curve in a first plane and a short reach curve in a plane 90° from the first, i.e., a first curve in one plane generally along the axis of the catheter tip section before it is deflected, and a second curve distal to the first curve in a plane transverse, and preferably normal to the first plane.
  • the high torque characteristic of the catheter tip section 13 reduces the tendency for the deflection in one quadrant to deform the deflection in the adjacent quadrant. Such a compound curve is shown in FIG. 7. This tendency may be further reduced and even eliminated by locating the distal ends of the second opposing pair of compression coils distal to the distal ends of the first opposing pair of compression coils, preferably at a location adjacent the anchor sites of the first opposing pair of puller wires.
  • Such a capability allows a physician to deflect the tip section 13 in a first direction to bring the distal tip near a desired site on the heart wall and then deflects the distal portion of the tip section from side to side, i.e., transverse to the first deflection, to reach around an obstruction such as a papillary muscle or chorda.
  • each of the four puller wires 31 may be anchored at the same location along the length of the catheter tip section 13 in which case the curvatures of the tip section 13 in all directions are the same and the tip section 13 can be made to deflect in any direction without rotation of the catheter body 12.
  • the puller wires 31 may be anchored at three or four different locations. In the latter case, each quadrant has a distinct curvature.
  • control handle 14 Longitudinal movement of the puller wires is controlled by control handle 14.
  • the control handle 14 comprises a generally cylindrical body 45, a distal cap 46 at the distal end of the control handle body 45 and a proximal cap 47 at its proximal end.
  • the cylindrical body 45 comprises a central cylindrical lumen 48 and four outer cylindrical lumens 49 which overlap with and hence communicate with the central lumen 48.
  • the cylindrical body 45 At its distal end, the cylindrical body 45 comprises a cylindrical flange 51.
  • a piston 52 comprising a movable member, is slidably mounted within each of the outer lumens 49 in the control handle 14 is a piston 52.
  • the piston 52 is generally cylindrical along about two-thirds of its length.
  • the proximal third of the piston is generally semicircular in cross-section having a flat surface 53 facing the axis of the control handle.
  • a preferred angle is about 45°.
  • the axial bore 58 has a distal section with a diameter slightly larger than the diameter of the puller wire 31 and a proximal section having a diameter larger than that of the distal section.
  • the entrance 59 to the axial bore is beveled.
  • the puller wire 31 extends through the axial bore 58 of the set screw 57 and is anchored thereto.
  • a preferred means for anchoring the puller wire 31 to the set screw 57 as shown in FIG. 10 comprises a short piece of hypodermic stock 61 which is fixedly attached, i.e., by crimping, to the proximal end of the puller wire 31 after it has passed through the distal section of the axial bore 58 of the set screw 57.
  • the hypodermic stock 61 has a diameter greater than the diameter of the distal section of the axial bore 58 and prevents the puller wire from being pulled through the set screw 52.
  • a cross-member e.g., stainless steel ribbon, may be welded to the proximal end of the puller wire such that the cross-member prevents the puller wire from being pulled through the axial bore of the set screw.
  • any mechanism for attaching the proximal end of the puller wire to the piston may be used.
  • each piston 52 there is provided a threaded, radial hole 62 into which a threaded post 63 is screwed.
  • the post 63 extends radially outwardly from the axis of the control handle 14 through a longitudinal slot 64 in the control handle body.
  • a button 65 At the end of the post 63, remote from the piston 52, there is fixedly attached a button 65.
  • This configuration completes a functional moveable member.
  • the movable member is slidably adjustable between two positions defined by the length of the slot 64. An operator may grip the outer surface of the control handle body 45 and slide the button 65 and piston 52 longitudinally the length of the slot 64 by means of thumb pressure.
  • buttons 65 are differentiated, e.g., by size, texture, etc., e.g., as shown in FIG. 9 to provide a tactile identification of the puller wire 31 which is being manipulated.
  • the buttons 65 associated with one puller wire pair may be knurled and the buttons associated with the other puller wire pair may be smooth. This avoids any confusion by a physician in manipulating the catheter during a medical procedure.
  • a control handle having a "light touch,” i.e., requiring only a small amount of pressure to slide the buttons 64 and hence making deflection off the tip section 13 very responsive to the physician's touch.
  • a handle 14 may prefer that the handle 14 require substantial pressure to slide the buttons 65 so that the tip curvature will remain when the button 65 is released.
  • a preferred button arrangement comprises a washer 71 and an O-ring 72 positioned between the button 65 and the body 45 of the control handle 14 and a compression spring 70 in surrounding relation to the post 63 between the button 65 and the washer 71.
  • rotation of the button 65 in one direction causes the post 63 to thread into the radial hole 62 of the piston 52 which increases the spring force and O-ring force pressing the washer 71 against the control handle body 45.
  • This increases the amount of frictional force that must be overcome to slide the button 65 along the length of the slot 64. Rotation of the button 65 in the opposite direction lessens such forces.
  • spring 70 and O-ring 72 cause the button 65 not to rotate during use and therefore, the friction force setting to remain locked once set.
  • the resolution of the friction setting mechanism may be varied as desired.
  • the distal cap 46 comprises a cylindrical portion 73 having a circumferential notch 74 at its proximal end.
  • the circumferential notch mates with the cylindrical flange 51 of the control handle body 45. That is, the outer diameter of the notch 74 is about the same as the inner diameter of the flange 51 of the control handle body 45.
  • the distal cap 46 is then press fit into the control handle body 45 until the distal edge of the flange 51 engages a shoulder 75 of the cap 46.
  • the distal cap 46 comprises a generally conical portion 76.
  • a small extension 77 projects distally at the top of the conical section 76.
  • the projection 77 comprises an axial hole through which the catheter body 12 extends and is fixedly attached thereto, e.g., by glue or the like.
  • Each of the puller wires 31 passes out of the proximal end of the catheter body 12 and extends through the distal cap 46 of the control handle 14 to a separate piston 52 within the control handle body 45.
  • the proximal ends of the puller wires 31 are fixed to the pistons 52, e.g., by means of the set screws 57 described above.
  • longitudinal movement of a piston 52 by means of pressure on the associated button 65 results in longitudinal movement of the puller wire 31 associated with that piston 52 and deflection of the tip section 13 in the direction of that puller wire quadrant.
  • puller wires 31 exit the cap 46 around a radius and then around another radius before entering the piston 52.
  • the first radius is a flaring of the hole in the cap 46.
  • the second radius is formed by an insert 79 which seats into the distal end of the central lumen 48 of the control handle 14.
  • the insert 79 comprises a rounded head portion having an outer surface adjacent the distal ends of the pistons 52.
  • the puller wires 31 pass from the catheter body 12 around the head portion of the insert 79 and then to the pistons.
  • the rounded head of the insert 79 assures that the puller wires 31 are generally co-axial with the pistons 52 at their points of attachment. This, in turn, avoids any sharp bends in the puller wires 31 at the points of attachment which could lead to weakening and potential breakage.
  • a movable stop 81 within the handle.
  • the stop comprises a central post 82 extending distally from the proximal cap 47 to a point adjacent the angled faces 54 of the pistons 52.
  • At the distal end of the post 82 there is an enlarged head 83 having a conical surface 84 similarly angled to the face 54 of the pistons 52.
  • the post 82 comprises an axial bore through which the electrode lead wires 36 may pass.
  • the angled face 54 of that piston 52 engages the conical surface 84 of the head 83 of the stop 81 causing the post 82 and head 83 to move off axis. If one attempts to move the diametrically opposed piston 52 proximately, the conical surface 84 of the head 83 will engage the angled face 54 surface of that piston 52 and prevent proximal movement. This is because, by virtue of the position of the first piston, the post 82 and head 83 cannot move out of the way of the second piston. Thus, the stop 81 allows only one piston of each pair of diametrically opposed pistons to be moved at one time.
  • the central lumen 18 is used for passage of electrode lead wires 36. It is understood that the central lumen may be omitted, if desired. In such an embodiment, one or more off-axis lumens 17 must be sufficiently large to carry the electrode lead wires 36 in addition to the compression coil 33 and the puller wire 31.
  • a preferred method for providing a lumen which carries a compression coil in surrounding relation to a puller wire and one or more electrode lead wires is described in U.S. Patent Application entitled DEFLECTABLE TIP ELECTRODE CATHETER WITH NYLON STIFFENER AND COMPRESSION COIL to Webster, Jr., filed May 20, 1997, the disclosure of which is incorporated herein by reference.
  • the compression coil is preferably covered by a non-conductive sheath to prevent electrical contact with the lead wires.
  • a tunnel must be formed in each of the glue joints securing the proximal and distal ends of the compression coil to the catheter body.
  • the tunnels provide means for passage of the electrode lead wires through the glue joints.
  • Such a tunnel may be formed, for example, by short pieces of polyimide tubing or the like.
  • the central lumen may be used as a delivery route for fluids, solids, devices, and the like (e.g., pharmaceutical compounds, growth factors, hormones, gene therapy vectors, angiography tracer substances, or angioplasty devices), or as a means for collecting tissue or fluid samples.
  • fluids solids, devices, and the like (e.g., pharmaceutical compounds, growth factors, hormones, gene therapy vectors, angiography tracer substances, or angioplasty devices), or as a means for collecting tissue or fluid samples.
  • the catheter body comprises a single central or axial lumen rather than multiple off-axis lumens.
  • the catheter 10 is as described above with reference to FIG. 1 in its external features.
  • the catheter body 12 comprises a single central lumen 90 through which four puller wires 31 extend.
  • the catheter body may be made of any suitable material and preferably comprises an outer polyurethane wall 91 containing a braided stainless steel mesh and an inner stiffening tube 92, the interior of which forms the central lumen 90.
  • the stiffening tube 92 may be made of any suitable material such as nylon or polyimide. Polyimide is presently preferred as the same degree of stiffness can be obtained with a thinner-walled tubing.
  • a compression coil 33 surrounds each puller wire 31 as described above.
  • the compression coils are fixedly attached at the proximal ends of the catheter body.
  • At the distal ends of the catheter body 12, at least one opposed pair of compression coils is fixedly attached to the catheter body by means of polyurethane glue joints 93 or the like as shown in FIG. 12.
  • a tunnel 94 is provided through the glue joint for passage of the electrode lead wires.
  • Preferred tunnels are formed by short pieces of non-conductive tubing, preferably polyimide tubing, for example as described in Webster, Jr. application filed May 20, 1997. In a preferred embodiment, shown in FIGS.
  • At least one opposed pair of compression coils extends past the junction of the catheter body 12 and the catheter tip 13 into the catheter tip, where the compression coils 33 are fixedly attached at a selected location along the length of the catheter tip by means of glue joints 34.
  • the compression coils 33 are fixedly attached at a selected location along the length of the catheter tip by means of glue joints 34.
  • one opposing pair of compression coils are fixedly attached along the length of the tip section at one location and the other opposing pair of compression coils are fixed along the length of the tip section at a second location distal to the first location.
  • the second location is where the distal ends of the first pair of puller wires 36 are attached to the wall of the tip section.
  • This configuration permits a first curve in one direction by one of the first pair of puller wires unaffected by the second puller wires and a second curve distal to the first curve in a direction 90° to the first curve unaffected by the first puller wire. Combined with the superior torsional characteristics, this embodiment allows the physician to steer the catheter in any direction and achieve a desired compound curve due to the stiffness afforded by the compression coils in the catheter body.
  • the tunnels 94 are formed centrally of the compression coils 33. It is understood that the tunnel 94 could be formed at a location between the compression coils 33 and the wall of the lumen 90 if desired.
  • the compression coils 33 are covered by a non-conductive sheath 95, preferably polyimide tubing. The presence of the sheath 95 around the compression coils 33 is preferred to prevent electrical contact between the electrode lead wires 36 and the compression coils 33 in the catheter body's single lumen.
  • the lead wires 36 are also encased in a non-conductive sheath 95, e.g., of polyimide tubing as shown in FIG. 11.
  • the catheter tip section 13 is as described above, with four off-axis lumens.
  • the puller wires branch into separate off-axis lumens and are anchored to the walls of the tip sections as described above.
  • the proximal ends of the puller wires are attached to a control handle, for example as described above.
  • the puller wires may extend through stiff nylon tubes or the like. Further, if the puller wires are maintained close to the axis of the catheter body, the compression coils (or nylon tubes or the like) through which the puller wires extend in the above embodiments may be omitted altogether.

Abstract

A multi-directional electrode catheter comprising an elongated tubular catheter body, a catheter tip section at the distal end of the catheter body and a control handle at the proximal end of the catheter. The catheter body may have a central lumen, and four off-axis lumens symmetrically positioned about the central lumen. A puller wire extends from the central handle through each off-axis lumen and is anchored to the tip section at a selected location. Within each off-axis lumen in the catheter body, there is provided a compression coil in surrounding relation to the puller wire. The compression coil is fixedly attached to the catheter body at its distal and proximal ends. At its proximal end, each puller wire is attached to a movable piston in the control handle. Moreover, each piston is controlled by an operator using a slidable button fixedly attached to each piston. Movement of a selected button results in movement of a selected puller wire and deflection of the tip section in the direction that puller wire.

Description

    FIELD OF THE INVENTION
  • This invention relates to catheters having steerable tips and particularly to a catheter having a tip which is steerable in multiple directions.
  • BACKGROUND OF THE INVENTION
  • Steerable or deflectable tip cardiovascular catheters are useful in many applications, being a marked improvement over catheters with fixed tip curves. They are especially useful in the field of electrophysiology for performing radio frequency ablation of abnormal electrical pathways in the heart.
  • There are presently several useful designs of steerable tip catheters. One such steerable tip catheter is described in Reissue Patent No. 34,502. The catheter has an elongated catheter body and tip portion which can be deflected into a semi-circle in one direction. In addition, the catheter body and tip portion can be rotated. Therefore by tip deflection, catheter rotation and catheter translation, i.e., lengthwise movement of the catheter, contact of the tip portion with most areas of a heart chamber may be made.
  • There are, however, structures and irregularity in the heart chambers which often make access difficult. In some cases it is necessary to reach around obstacles to contact a desired site. Moreover, it may be necessary to use a longer or shorter deflectable tip portion to reach a particular site and maintain adequate stable contact.
  • One early multidirectional deflectable tip catheter had a catheter body and tip with 5 lumens, i.e., a central lumen and four outer lumens disposed symmetrically around the central lumen. This catheter had four puller wires which extended through the outer lumens. The distal ends of the puller wires were attached to a ring at the tip and the proximal ends were attached to a "joy stick". The central lumen was open at its distal end and connected to a luer hub at its proximal end. This catheter had no reinforcement in its body or tip. It was not suitable for electrophysiology because it had effectively no torque transmission to the tip which made tip rotation difficult. Moreover, the catheter body was subject to the same deflection as the tip, but to a lesser degree.
  • A more recent steerable catheter has a steerable tip that is controlled by a bendable control handle. Multiple puller wires connect the steerable tip to this control handle which can be bent in any direction and can be thought of as a multiple ball joint with friction. The tip, once deflected, can be further deflected laterally by an internal stylette. The disadvantage of this catheter design is that the tip is very soft and has poor lateral stiffness due to the presence of the stylette which cannot transmit torque effectively. Because of this, an electrode at the tip of the catheter cannot be held firmly against the myocardial wall.
  • Another recent steerable tip catheter comprises a deflectable tip which can be deflected in one direction by a puller wire and further deflected laterally by an internal stylette. The stylette can also be moved axially within the catheter to change the shape of the tip curvature. The disadvantage of this catheter design is that the lateral stiffness of the tip is dependent upon the stylette which cannot transmit torque effectively.
  • In a design wherein the tip is rotated by means of a stylette, it follows that the lateral stiffness of the tip must be less than that of the stylette alone. This is because some torque from the stylette is required to rotate the tip. Moreover, the stylet must be kept small to allow the catheter body and tip to bend and to be safe within the patient body and heart.
  • SUMMARY OF THE INVENTION
  • The present invention provides a cardiovascular catheter comprising a steerable catheter tip section, an elongated catheter body and a control handle. The catheter tip section comprises at least two and preferably four off-axis lumens. The catheter body comprises at least one lumen in communication with the off-axis lumens of the catheter tip section. Preferably, the catheter body comprises a single lumen in communication with four off-axis lumens in the catheter tip section. In an alternately preferred embodiment, the catheter body comprise separate off-axis lumen aligned with each off-axis lumen of the catheter tip section. The control handle which is attached to the proximal end of the catheter body, comprises a separate movable, preferably slidable, member associated with each of the off-axis lumens of the catheter tip section.
  • An elongated puller wire is connected at its proximal end to each of the movable members of the control handle. Each puller wire extends through a lumen of the catheter body into the off-axis lumen in the catheter tip section and is anchored at its distal end to the wall of the catheter tip section or to a tip electrode. Movement of a movable member in the control handle results in movement of the puller wire connected to that movable member in a proximal direction relative to the catheter body and deflection of the tip section in the direction of the moved puller wire.
  • Preferably, the movable members are slidable within the control handle. An elongated puller wire is attached at the proximal end to each of the slidable members in the control handle. Each puller wire extends through a lumen in the catheter body into an off axis lumen in the catheter tip section and is anchored either in the lumen wall or in a tip electrode. Proximal movement of a slidable member results in proximal movement of its puller wire relative to the catheter body and deflection of the catheter tip in that off axis direction.
  • Means are preferably provided for resisting compression forces on the catheter body when a puller wire is moved in a proximal direction relative to the catheter body. Preferred means comprise a compression coil which extends through the catheter body in surrounding relation to each puller wire. The proximal end of the compression coil is fixedly attached to the proximal end of the catheter body and the distal end of the compression coil is fixedly attached to the distal end of the catheter body and/or at a selected location along the length of the catheter tip section. The site of the distal attachment of the compression coil and the anchor site of the puller wire associated with that compression coil in the tip section determine the length of the tip deflection curvature in the direction of that puller wire.
  • In a preferred embodiment of the invention, the catheter body and tip section contain four lumens arranged symmetrically in quadrants through which four puller wires extend. Each puller wire extends through a separate lumen from the control handle through the catheter body to an anchor site in the tip section. Within the catheter body, each lumen contains a compression coil in surrounding relation to the puller wire for resisting the compressive force of the puller wire, thereby preventing deflection of the catheter body. The compression coil is fixedly attached to the proximal end of the catheter body and also near the transition of the catheter body to the tip section.
  • In a particularly preferred embodiment of the invention, the puller wires are separated into first and second pairs, each pair containing diametrically opposed puller wires. The anchor sites of the first pair of puller wires in the tip section are more proximal to the distal end of the tip section than the anchor sites of the second pair. In this arrangement, proximal movement of a puller wire from the first pair results in a first curve of the proximal portion of the catheter tip in the direction of the quadrant of that puller wire generally in a plane containing the axis of the catheter body. Thereafter, proximal movement of an adjacent puller wire of the second pair results in a second, more distal curve in the direction of that adjacent puller wire quadrant in a plane generally transverse to the axis of the catheter body. Such a compound curve is particularly useful in reaching around obstructions such as a papillary muscle or chorda within the heart.
  • In a preferred embodiment of the invention, there is provided a fifth lumen located central to the four quadrant lumens. The fifth lumen runs the full length of the catheter body and tip section, or the full length of the tip section alone in a preferred embodiment. In an electrophysiology catheter, the fifth lumen may serve to carry the electrode lead wires. In other instances the fifth lumen may be open at its distal end to conduct fluids into or out of the vascular system. It may also serve to conduct other energy delivery devices such as an optical fiber, to carry a fiber optic bundle for direct viewing, to inflate a balloon, to serve as a conduit for needles and the like or other useful interventions.
  • In another preferred embodiment of the invention, the catheter body has a single central lumen into which the four puller wires and the lead wires from the five lumen tip converge and travel the full length of the body into the control handle. In this embodiment, the compression coils may be retained or omitted. Preferably, however, compression coils are included and the proximal ends of each of two diametrically opposed pairs of compression coils are fixedly anached to the proximal end of the catheter body. The distal ends of the compression coils are fixedly attached to the distal end of the catheter body and/or at a selected location along the length of the catheter tip section. In a preferred embodiment where one diametrically opposed pair of compression coils extends into the catheter tip and the other pair is fixedly attached to the distal end of the catheter body, it is preferable that the pair of compression coils extending into the tip is fixedly attached at a location on the tip section where the distal end of the puller wires of the other opposed pair of compression coils are fixedly attached.
  • Longitudinal movement of the puller wires is accomplished by means of the control handle. A preferred control handle comprises a handle body having four movable, or slidable, members. Each slidable member is connected to a puller wire so that movement, preferably proximal movement, of a slidable member from a first position towards a second position results in proximal movement of the puller wire associated with that member with respect to the catheter body and deflection of the tip section in the direction of that puller wire quadrant. Preferably, means are provided to prevent simultaneous proximal movement of diametrically opposed buttons.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • These and other features and advantages of the present invention will be better understood by reference to the following detailed description when considered in conjunction with the accompanying drawings wherein:
  • FIG. 1 is side view showing a preferred omni-directional catheter constructed in accordance with the present invention.
  • FIG.2 is a transverse cross-sectional view of one embodiment of a catheter body showing the lumen arrangement.
  • FIG. 3 is a longitudinal cross-sectional view showing a preferred means for joining a catheter tip section to the catheter body.
  • FIG. 4 is a longitudinal cross-sectional view of the catheter tip section showing a preferred means for anchoring the puller wires.
  • FIG. 5a is a longitudinal cross-sectional view of a preferred puller wire T-bar anchor.
  • FIG. 5b is a longitudinal cross-sectional view of a preferred puller wire T-bar anchor of FIG. 5a rotated 90° to show the cross-piece on end.
  • FIGs. 6a and 6b are longitudinal cross-sectional views of the catheter tip section showing other preferred means for anchoring the puller wires.
  • FIG. 7 is a perspective view of a tip section deflected into a compound curve.
  • FIG. 8 in a longitudinal cross-sectional view of a preferred control handle.
  • FIG. 9 is a transverse cross-sectional view of the control handle of FIG. 8 taken along line 9-9 without insert 79.
  • FIG. 10 is a transverse cross-sectional view of a preferred means for securing the puller wire to the control handle.
  • FIG. 11 is a transverse cross-sectional view of a presently preferred catheter body construction.
  • FIG. 12 is a longitudinal cross-sectional view of the proximal end of the catheter body of FIG. 11.
  • FIG. 13 is longitudinal cross-sectional view of a preferred means of joining a catheter body to the deflectable catheter tip and of attaching compression coils to the deflectable tip.
  • FIG. 14 is a transverse cross-sectional view of the tip section of FIG. 13 taken along line 14-14.
  • DETAILED DESCRIPTION
  • A particularly preferred deflectable electrode catheter constructed in accordance with the present invention as shown in FIGS. 1 - 10. In FIG. 1, the catheter 10 comprises an elongated catheter body 12, a deflectable tip section 13 and a control handle 14. In the embodiment shown, the tip section 13 carries a plurality of electrodes 28 and 29.
  • The overall length and diameter of the catheter may vary according to the application. A presently preferred catheter has an overall length of about 48 inches and an outer diameter of about 0.09 inches.
  • With reference to FIG. 2, the catheter body 12 comprises an elongated tubular construction having four outer lumens 17 and a central lumen 18. The outer lumens 17 are arranged symmetrically into quadrants about the central lumen 18. The diameter of the lumens may vary as desired. In a preferred embodiment, each of the lumens has a diameter of about 0.018 inch. The catheter body 12 is made of any suitable non-toxic material such as polyurethane. The catheter body 12 is preferably reinforced with at least one layer of a braided mesh 15 of stainless steel or the like to increase its torsional stiffness.
  • With reference to FIG. 4, the catheter tip section 13 comprises a short section of flexible tubing 21 having a central lumen 22 and four outer lumens 23 positioned symmetrically about the central lumen 22 as in the catheter body 12. The tubing 21 is made of a suitable material and is preferably more flexible than the catheter body 12. A presently preferred material for the catheter tip section 13 is polyurethane. The catheter tip section 13 is preferably reinforced with a metallic braided mesh 24 similar to that on the catheter body 12 to impart the same high torque characteristics without appreciably increasing its bending stiffness.
  • The diameter of the catheter tip section 13 is preferably the same as or slightly smaller than that of the catheter body 12. In a preferred embodiment, the diameter of the catheter tip section is about 0.08-0.09 inches and the length is about 3 inches.
  • A preferred means for attaching the catheter tip section 13 to the catheter body 12 is illustrated in FIG. 3. The proximal end of the catheter tip section 13 comprises an outer circumferential notch 26 and the distal end of the catheter body 12 comprises an inner circumferential notch 27. The notches 26 and 27 are sized such that the proximal end of the catheter tip section 13 fits snugly into the distal end of the catheter body 12. The catheter tip section 13 is then fixedly attached to the catheter body by polyurethane glue or the like, creating a seam on the outer surface of the catheter at the junction between the catheter tip section 13 and the catheter body 12. The central lumen 22 and outer lumens 23 of the catheter tip section 13 are aligned with and communicate with the central lumen 18 and outer lumens 17 of the catheter body 12 respectively.
  • Along the length of the catheter tip section 13 are a plurality of ring electrodes 28. The length of the electrodes 28 is not critical but is preferably about one to four millimeters. The electrodes 28 are spaced apart a distance of about 2 to 4 millimeters. A tip electrode 29 is at the distal end of the tip section 13.
  • Each electrode 28 and 29 is connected to a separate lead wire 36 which extends through the central lumens 18 and 22.
  • The proximal ends of lead wires 36 are connected to an appropriate jack or other connector which can be plugged into or otherwise connected to a suitable monitor.
  • Each ring electrode 28 has an associated lead wire 36 which extends through the wall of the tip section to the electrode. Connection of the lead wires 36 to the electrode 28 is accomplished, for example, by first making a small hole through the wall of the catheter tip section 13 and into the central lumen 22. Such a hole may be created, for example, by inserting a needle through the tip section wall and heating the needle sufficiently to form a permanent hole. A lead wire 36 is then drawn through the hole by using a microhook or the like. The ends of the lead wire 36 are then stripped of any coating and soldered or welded to the underside of the electrode 28 which is then slid into position over the hole and fixed in place with polyurethane glue or the like.
  • A puller wire 31 extends from the control handle 14 through each of the outer lumens 17 in the catheter body 12 and into aligned outer lumen 23 of the tip section 13. The puller wire 31 is made of any suitable metal such as stainless steel or Nitinol and is coated with Teflon®, Kevlor, carbon fiber or the like. The puller wire has a diameter preferably from about 0.006 to about 0.010 inch.
  • With reference to FIG. 2, within the catheter body 12, there is provided a compression coil 33 extending through each outer lumen 17 in surrounding relation to each puller wire 31. The compression coil 33 is made of a suitable metal, e.g., stainless steel, which is tightly wound on itself to provide flexibility, i.e., bending, but to resist compression. The inner diameter of the compression coil 33 is selected to be slightly larger than the diameter of the puller wire 31. For example, when the puller wire 31 has a diameter of about 0.007 inch, a compression coil 33 having an inner diameter of about 0.008 inch is presently preferred. The outer diameter of the compression coil 33 is likewise slightly smaller than the diameter of the lumen 17 through which it extends. For example, if the outer lumen 17 has a diameter of about 0.018 inch, the compression coil 33 preferably has an outer diameter of about 0.017 inch.
  • The compression coil 33 is fixedly attached to the proximal and distal ends of the catheter body 12 by polyurethane glue or the like. The glue may be applied through a syringe or the like to the outer circumference of the ends of the compression coil 33, for example as shown in FIG. 3 as location A. Glue applied to this location wicks inwardly between the compression coil 33 and the wall forming the lumen 17. Upon curing, the glue joint 34 is formed. Alternatively, the glue may be applied by means of a syringe or the like through a hole between the outer surface of the catheter body 12 and the lumen 17. Such a hole may be formed for example by a needle or the like which punctures the catheter body wall and is heated sufficiently to form a permanent hole. The glue is introduced through the hole to the outer surface of the compression coil 33 and wicks around the outer circumference to form a glue joint 34 about the entire circumference of the compression coil 33.
  • If the latter method is used, it is understood that the distal end of the compression coil 33 could be located in the proximal portion of the catheter tip section 13 rather from at the distal end of the catheter body 12. Such an embodiment provides added support to the juncture of the catheter body 12 and catheter tip section 13. Each puller wire 31 is preferably coated with a very thin coating of Teflon®. This coating imparts lubricity to the puller wire 31 within the compression coil 33.
  • Each puller wire 31 is anchored to the side of the catheter tip section 13 or to a tip electrode. With reference to FIGS. 4 and 5, within the tip section 13 the Teflon® sheath 32 prevents the puller wire from cutting into the wall of the tip section 13 when the tip section 13 is deflected. At its distal end, the puller wire 31 extends beyond the Teflon® sheath 32. The Teflon® coating on the puller wire 31 may also be removed at the distal end of the puller wire 31 or left on under the anchor 35. An anchor 35 is fixedly attached to the distal end of the puller wire 31. In a preferred embodiment, the anchor is formed by a metal tube 37, e.g., a short segment of hypodermic stock. which is fixedly attached; e.g., by crimping, to the distal end of the puller wire. The tube 37 has a section which extends a short distance beyond the distal end of the puller wire 31. A cross-piece 38 made of a small section of stainless steel ribbon or the like is soldered or welded in a transverse arrangement to the distal end of the tube section 37 which is flattened during the operation. This creates a T-bar anchor 35. A notch 39 is created in the side of the catheter tip section 13 resulting in an opening into the outer lumen 23. The anchor 35 lies particularly within the notch 39. Because the length of the ribbon forming the cross-piece 38 is longer than the diameter of the opening into the lumen 23, the anchor cannot be pulled completely into the lumen 23. The notch 39 is then sealed with polyurethane 40 or the like to give a smooth outer surface.
  • In a preferred embodiment, the puller wires 31 are divided into two pairs, a first pair being anchored proximal to the anchor location of the second pair. The second pair is anchored to the wall of the tip section 13 adjacent the distal end of tip section 13 or to a tip electrode. The first pair of puller wires 31 are anchored to the wall of the tip section at a location spaced apart proximally from the anchor sites of the second pair. In such an arrangement, the first pair may be anchored to the side wall of the tip section 13 as described above or, alternatively, may be anchored at the distal end of the tip section 13 as shown in FIG. 6A. In this arrangement, the puller wire 31 extends to the distal end of the outer lumen with the anchor, which is attached to the end of the puller wire, lying beyond the end of the lumen 23. The anchor 35 is fixed in this position by a polyurethane cap 41 which also seals the distal end of the catheter tip section 13. Because the cross-piece is longer than the diameter of the lumen 23 the anchor 35 cannot be pulled back into the lumen when the tip section 13 is deflected. This alternative anchoring method is useful when there is no tip electrode 29. If a tip electrode 29 is present, the puller wires 31 may be anchored to the side wall of the tip section 13 or to the tip electrode 29, e.g., by solder, as shown in FIG. 6B.
  • The distance between the distal end of the compression coil 33 and the anchor sites of the puller wire 31 in the tip section 13 determines the curvature of the tip section 13 in the direction of that puller wire 31. For example, the arrangement of the anchor sites of the puller wires 31 described above, i.e., two diametrically opposed pairs anchored at different distances from the distal end of the compression coil 33, allows a long reach curve in a first plane and a short reach curve in a plane 90° from the first, i.e., a first curve in one plane generally along the axis of the catheter tip section before it is deflected, and a second curve distal to the first curve in a plane transverse, and preferably normal to the first plane. The high torque characteristic of the catheter tip section 13 reduces the tendency for the deflection in one quadrant to deform the deflection in the adjacent quadrant. Such a compound curve is shown in FIG. 7. This tendency may be further reduced and even eliminated by locating the distal ends of the second opposing pair of compression coils distal to the distal ends of the first opposing pair of compression coils, preferably at a location adjacent the anchor sites of the first opposing pair of puller wires. Such a capability allows a physician to deflect the tip section 13 in a first direction to bring the distal tip near a desired site on the heart wall and then deflects the distal portion of the tip section from side to side, i.e., transverse to the first deflection, to reach around an obstruction such as a papillary muscle or chorda.
  • It is understood that each of the four puller wires 31 may be anchored at the same location along the length of the catheter tip section 13 in which case the curvatures of the tip section 13 in all directions are the same and the tip section 13 can be made to deflect in any direction without rotation of the catheter body 12. Alternatively, the puller wires 31 may be anchored at three or four different locations. In the latter case, each quadrant has a distinct curvature. By rotating the catheter body 12, which is possible due to the high torque shaft, a physician may use any of the four curvatures or combinations thereof as desired.
  • Longitudinal movement of the puller wires is controlled by control handle 14. With reference to FIGS. 8-10, the control handle 14 comprises a generally cylindrical body 45, a distal cap 46 at the distal end of the control handle body 45 and a proximal cap 47 at its proximal end. The cylindrical body 45 comprises a central cylindrical lumen 48 and four outer cylindrical lumens 49 which overlap with and hence communicate with the central lumen 48. At its distal end, the cylindrical body 45 comprises a cylindrical flange 51. A piston 52, comprising a movable member, is slidably mounted within each of the outer lumens 49 in the control handle 14 is a piston 52. The piston 52 is generally cylindrical along about two-thirds of its length. The proximal third of the piston is generally semicircular in cross-section having a flat surface 53 facing the axis of the control handle. At the transition between the distal cylindrical portion and the proximal semi-cylindrical portion of the piston, there is an angled, generally flat face 54. A preferred angle is about 45°.
  • With reference to FIG. 10, at the distal end of the piston 52, there is a threaded axial hole 56 which receives a threaded set screw 57. The set screw has an axial bore 58 therethrough for passage of the proximal end of the puller wire 31. In a preferred embodiment, the axial bore 58 has a distal section with a diameter slightly larger than the diameter of the puller wire 31 and a proximal section having a diameter larger than that of the distal section. The entrance 59 to the axial bore is beveled.
  • The puller wire 31 extends through the axial bore 58 of the set screw 57 and is anchored thereto. A preferred means for anchoring the puller wire 31 to the set screw 57 as shown in FIG. 10 comprises a short piece of hypodermic stock 61 which is fixedly attached, i.e., by crimping, to the proximal end of the puller wire 31 after it has passed through the distal section of the axial bore 58 of the set screw 57. The hypodermic stock 61 has a diameter greater than the diameter of the distal section of the axial bore 58 and prevents the puller wire from being pulled through the set screw 52. As an alternative, a cross-member, e.g., stainless steel ribbon, may be welded to the proximal end of the puller wire such that the cross-member prevents the puller wire from being pulled through the axial bore of the set screw.
  • It is understood that any mechanism for attaching the proximal end of the puller wire to the piston may be used.
  • Along the length of each piston 52, there is provided a threaded, radial hole 62 into which a threaded post 63 is screwed. The post 63 extends radially outwardly from the axis of the control handle 14 through a longitudinal slot 64 in the control handle body. At the end of the post 63, remote from the piston 52, there is fixedly attached a button 65. This configuration completes a functional moveable member. In this arrangement, the movable member is slidably adjustable between two positions defined by the length of the slot 64. An operator may grip the outer surface of the control handle body 45 and slide the button 65 and piston 52 longitudinally the length of the slot 64 by means of thumb pressure. In a particularly preferred embodiment, the buttons 65 are differentiated, e.g., by size, texture, etc., e.g., as shown in FIG. 9 to provide a tactile identification of the puller wire 31 which is being manipulated. For example, in the embodiment described above involving two diametrically opposed pairs of puller wires 31, each pair anchored at different sites along the length of the tip section, the buttons 65 associated with one puller wire pair may be knurled and the buttons associated with the other puller wire pair may be smooth. This avoids any confusion by a physician in manipulating the catheter during a medical procedure.
  • In a preferred embodiment, there is provided means for adjusting the amount of manual pressure required to slide a button 65 along the length of the slot 64. For example, one physician may desire a control handle having a "light touch," i.e., requiring only a small amount of pressure to slide the buttons 64 and hence making deflection off the tip section 13 very responsive to the physician's touch. Another may prefer that the handle 14 require substantial pressure to slide the buttons 65 so that the tip curvature will remain when the button 65 is released.
  • With reference to FIG. 8, a preferred button arrangement comprises a washer 71 and an O-ring 72 positioned between the button 65 and the body 45 of the control handle 14 and a compression spring 70 in surrounding relation to the post 63 between the button 65 and the washer 71. In this arrangement, rotation of the button 65 in one direction causes the post 63 to thread into the radial hole 62 of the piston 52 which increases the spring force and O-ring force pressing the washer 71 against the control handle body 45. This increases the amount of frictional force that must be overcome to slide the button 65 along the length of the slot 64. Rotation of the button 65 in the opposite direction lessens such forces.
  • The combination of spring 70 and O-ring 72 cause the button 65 not to rotate during use and therefore, the friction force setting to remain locked once set. By the choice of spring 70, O-ring 72 and thread pitch, the resolution of the friction setting mechanism may be varied as desired.
  • The distal cap 46 comprises a cylindrical portion 73 having a circumferential notch 74 at its proximal end. The circumferential notch mates with the cylindrical flange 51 of the control handle body 45. That is, the outer diameter of the notch 74 is about the same as the inner diameter of the flange 51 of the control handle body 45. The distal cap 46 is then press fit into the control handle body 45 until the distal edge of the flange 51 engages a shoulder 75 of the cap 46. Above the cylindrical portion, the distal cap 46 comprises a generally conical portion 76. A small extension 77 projects distally at the top of the conical section 76. The projection 77 comprises an axial hole through which the catheter body 12 extends and is fixedly attached thereto, e.g., by glue or the like.
  • Each of the puller wires 31 passes out of the proximal end of the catheter body 12 and extends through the distal cap 46 of the control handle 14 to a separate piston 52 within the control handle body 45. The proximal ends of the puller wires 31 are fixed to the pistons 52, e.g., by means of the set screws 57 described above. In this arrangement, longitudinal movement of a piston 52 by means of pressure on the associated button 65 results in longitudinal movement of the puller wire 31 associated with that piston 52 and deflection of the tip section 13 in the direction of that puller wire quadrant.
  • To assure that the puller wires 31 transition smoothly from the catheter body 12 to their anchor sites on the pistons 52, puller wires 31 exit the cap 46 around a radius and then around another radius before entering the piston 52. The first radius is a flaring of the hole in the cap 46. The second radius is formed by an insert 79 which seats into the distal end of the central lumen 48 of the control handle 14. The insert 79 comprises a rounded head portion having an outer surface adjacent the distal ends of the pistons 52. The puller wires 31 pass from the catheter body 12 around the head portion of the insert 79 and then to the pistons. The rounded head of the insert 79 assures that the puller wires 31 are generally co-axial with the pistons 52 at their points of attachment. This, in turn, avoids any sharp bends in the puller wires 31 at the points of attachment which could lead to weakening and potential breakage.
  • To prevent simultaneous movement of diametrically opposed puller wires 31 and yet allow for simultaneous movement of any two adjacent puller wires, there is provided a movable stop 81 within the handle. The stop comprises a central post 82 extending distally from the proximal cap 47 to a point adjacent the angled faces 54 of the pistons 52. At the distal end of the post 82, there is an enlarged head 83 having a conical surface 84 similarly angled to the face 54 of the pistons 52. The post 82 comprises an axial bore through which the electrode lead wires 36 may pass.
  • When one piston is moved proximally, the angled face 54 of that piston 52 engages the conical surface 84 of the head 83 of the stop 81 causing the post 82 and head 83 to move off axis. If one attempts to move the diametrically opposed piston 52 proximately, the conical surface 84 of the head 83 will engage the angled face 54 surface of that piston 52 and prevent proximal movement. This is because, by virtue of the position of the first piston, the post 82 and head 83 cannot move out of the way of the second piston. Thus, the stop 81 allows only one piston of each pair of diametrically opposed pistons to be moved at one time.
  • In the embodiment described above, the central lumen 18 is used for passage of electrode lead wires 36. It is understood that the central lumen may be omitted, if desired. In such an embodiment, one or more off-axis lumens 17 must be sufficiently large to carry the electrode lead wires 36 in addition to the compression coil 33 and the puller wire 31. A preferred method for providing a lumen which carries a compression coil in surrounding relation to a puller wire and one or more electrode lead wires is described in U.S. Patent Application entitled DEFLECTABLE TIP ELECTRODE CATHETER WITH NYLON STIFFENER AND COMPRESSION COIL to Webster, Jr., filed May 20, 1997, the disclosure of which is incorporated herein by reference. In such an embodiment, the compression coil is preferably covered by a non-conductive sheath to prevent electrical contact with the lead wires. Moreover, a tunnel must be formed in each of the glue joints securing the proximal and distal ends of the compression coil to the catheter body. The tunnels provide means for passage of the electrode lead wires through the glue joints. Such a tunnel may be formed, for example, by short pieces of polyimide tubing or the like.
  • Alternatively, if the lead wires 36 are carried in one or more of the off-axis lumens, the central lumen may be used as a delivery route for fluids, solids, devices, and the like (e.g., pharmaceutical compounds, growth factors, hormones, gene therapy vectors, angiography tracer substances, or angioplasty devices), or as a means for collecting tissue or fluid samples.
  • In another particularly preferred embodiment of the invention, the catheter body comprises a single central or axial lumen rather than multiple off-axis lumens. The catheter 10 is as described above with reference to FIG. 1 in its external features. In this preferred embodiment, shown in FIG. 11, the catheter body 12 comprises a single central lumen 90 through which four puller wires 31 extend. The catheter body may be made of any suitable material and preferably comprises an outer polyurethane wall 91 containing a braided stainless steel mesh and an inner stiffening tube 92, the interior of which forms the central lumen 90. The stiffening tube 92 may be made of any suitable material such as nylon or polyimide. Polyimide is presently preferred as the same degree of stiffness can be obtained with a thinner-walled tubing.
  • A compression coil 33 surrounds each puller wire 31 as described above. The compression coils are fixedly attached at the proximal ends of the catheter body. At the distal ends of the catheter body 12, at least one opposed pair of compression coils is fixedly attached to the catheter body by means of polyurethane glue joints 93 or the like as shown in FIG. 12. A tunnel 94 is provided through the glue joint for passage of the electrode lead wires. Preferred tunnels are formed by short pieces of non-conductive tubing, preferably polyimide tubing, for example as described in Webster, Jr. application filed May 20, 1997. In a preferred embodiment, shown in FIGS. 13 and 14, at least one opposed pair of compression coils extends past the junction of the catheter body 12 and the catheter tip 13 into the catheter tip, where the compression coils 33 are fixedly attached at a selected location along the length of the catheter tip by means of glue joints 34. Preferably one opposing pair of compression coils are fixedly attached along the length of the tip section at one location and the other opposing pair of compression coils are fixed along the length of the tip section at a second location distal to the first location. In a particularly preferred embodiment, the second location is where the distal ends of the first pair of puller wires 36 are attached to the wall of the tip section. This configuration permits a first curve in one direction by one of the first pair of puller wires unaffected by the second puller wires and a second curve distal to the first curve in a direction 90° to the first curve unaffected by the first puller wire. Combined with the superior torsional characteristics, this embodiment allows the physician to steer the catheter in any direction and achieve a desired compound curve due to the stiffness afforded by the compression coils in the catheter body.
  • In the embodiment shown in FIG. 12, the tunnels 94 are formed centrally of the compression coils 33. It is understood that the tunnel 94 could be formed at a location between the compression coils 33 and the wall of the lumen 90 if desired. Between the glue joints 93, the compression coils 33 are covered by a non-conductive sheath 95, preferably polyimide tubing. The presence of the sheath 95 around the compression coils 33 is preferred to prevent electrical contact between the electrode lead wires 36 and the compression coils 33 in the catheter body's single lumen. Preferably, the lead wires 36 are also encased in a non-conductive sheath 95, e.g., of polyimide tubing as shown in FIG. 11.
  • The catheter tip section 13 is as described above, with four off-axis lumens. In the tip section, the puller wires branch into separate off-axis lumens and are anchored to the walls of the tip sections as described above. Likewise, the proximal ends of the puller wires are attached to a control handle, for example as described above.
  • In the latter preferred embodiment, it is understood that, rather than compression coils, the puller wires may extend through stiff nylon tubes or the like. Further, if the puller wires are maintained close to the axis of the catheter body, the compression coils (or nylon tubes or the like) through which the puller wires extend in the above embodiments may be omitted altogether.
  • The preceding description has been presented with reference to presently preferred embodiments of the invention. Workers skilled in the art and technology to which this invention pertains will appreciate that alterations and changes in the described structure may be practiced without meaningfully departing from the principal, spirit and scope of this invention.
  • Accordingly, the foregoing description should not be read as pertaining only to the precise structures described and illustrated in the accompanying drawings, but rather should be read consistent with and as support to the following claims which are to have their fullest and fair scope.

Claims (10)

  1. A multi-directional catheter comprising
    an elongated catheter body having proximal and distal ends and at least one lumen therethrough;
    a catheter tip section at the distal end of the catheter body having at least two off-axis lumens;
    a control handle at the proximal end of the catheter body, said control handle comprising a movable member associated with each off-axis lumen of the tip section, said member being movable between first and second positions;
    an elongated puller wire having proximal and distal ends associated with each movable member of the control handle, each puller wire being connected at its proximal end to its associated movable member of the control handle and extending through the lumen of the catheter body and into the off-axis lumen in the catheter tip section associated with the movable member to which the puller wire is connected, the distal end of each puller wire being anchored to one of a tip electrode and the wall of the tip section at a selected location; and
    wherein movement of a selected movable member from its first position toward its second position results in deflection of the tip section in the direction of the off-axis lumen associated with the selected movable member.
  2. A multi-direction catheter as claimed in claim 1 wherein the puller wires are anchored to the tip section at least two different selected locations along the length of the tip section.
  3. A multi-directional catheter as claimed in claim 1 wherein the catheter body comprises an off-axis lumen aligned with each off-axis lumen of the tip section.
  4. A multi-directional catheter as claimed in claim 1 wherein the catheter body comprises means for resisting compressive forces generated when a puller wire is moved in a proximal direction relative to the catheter body.
  5. A multi-directional catheter as claimed in claim 4 wherein the means for resisting compressive forces comprises a compression coil associated with and being in surrounding relation to its associated puller wire, each compression coil having proximal and distal ends and extending through the lumen in the catheter body, each compression coil being fixedly attached at its proximal end to the proximal end of the catheter body and being fixedly attached at its distal end to one of the distal end of the catheter body and the proximal end of the catheter tip section.
  6. A multi-directional catheter as claimed in claim 4 wherein the means for resisting compressive forces comprises a compression coil associated with and being in surrounding relation to its associated puller wire, each compression coil having proximal and distal ends and extending through the lumen in the catheter body, each compression coil being fixedly attached at its proximal end to the proximal end of the catheter body and being fixedly attached at its distal end to a selected location along the length of the catheter tip section.
  7. A multi-directional catheter as claimed in claim 1 wherein the tip section comprises four off axis lumens.
  8. A multi-directional catheter as claimed in claim 7 wherein the catheter body comprises four off axis lumens aligned with the off-axis lumens of the tip section.
  9. A multi-directional catheter as claimed in claim 6 wherein the movable member comprises a slidably movable piston.
  10. A multi-directional catheter as claimed in claim 1 wherein the catheter body comprises one lumen and the tip comprises four off-axis lumens.
EP98307161A 1997-09-05 1998-09-04 Omni-directional steerable catheter Expired - Lifetime EP0904796B1 (en)

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US08/924,611 US6123699A (en) 1997-09-05 1997-09-05 Omni-directional steerable catheter

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Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1099453A2 (en) 1999-11-12 2001-05-16 Biosense Webster, Inc. Injection catheter
EP1151726A1 (en) 2000-05-01 2001-11-07 Biosense Webster, Inc. Catheter with enhanced ablation electrode
EP1169972A1 (en) 2000-07-07 2002-01-09 Biosense Webster, Inc. Mapping and ablation catheter
EP1205207A1 (en) 2000-11-09 2002-05-15 Biosense Webster, Inc. Injection catheter with controllably extendable injection needle
EP1251768A1 (en) * 2000-02-01 2002-10-30 David L. Pruitt Multi-lumen medical device
EP1254641A2 (en) * 2001-04-30 2002-11-06 Biosense Webster, Inc. Asymmetrical bidirectional steerable catheter
EP1429649A2 (en) * 2001-09-24 2004-06-23 Novoste Corporation Methods and apparatus employing ionizing radiation for treatment of cardiac arrhythmia
EP0980693B1 (en) * 1998-08-14 2005-01-12 Biosense Webster, Inc. Bi-directional steerable catheter
US6875170B2 (en) 2000-04-21 2005-04-05 Universite Pierre Et Marie Curie Positioning, exploration, and/or intervention device, in particular in the field of endoscopy and/or mini-invasive surgery
EP1690510A1 (en) 2005-02-14 2006-08-16 Biosense Webster, Inc. Irrigated tip catheter and method for manufacturing therefor
EP1803481A2 (en) 2005-12-30 2007-07-04 Biosense Webster, Inc. Dual-lever bi-directional handle
EP1852082A1 (en) * 2006-05-01 2007-11-07 Ethicon Endo-Surgery, Inc. Dual-bending sphinctertome
US7416547B2 (en) 1999-03-29 2008-08-26 Biosense Webster Inc. Injection catheter
WO2009120945A1 (en) 2008-03-27 2009-10-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter device cartridge
US7905864B2 (en) 1998-06-04 2011-03-15 Biosense Webster, Inc. Injection catheter with multi-directional delivery injection needle
EP2363152A1 (en) * 2000-09-06 2011-09-07 Johns Hopkins University Cardiac arrhythmia treatment methods
EP2424609A1 (en) * 2009-04-29 2012-03-07 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
CN103079626A (en) * 2010-08-10 2013-05-01 日本来富恩株式会社 Catheter
EP2591819A1 (en) 2011-11-10 2013-05-15 Biosense Webster (Israel), Ltd. Medical device control handle with multiplying linear motion
US8977344B2 (en) 1998-06-04 2015-03-10 Biosense Webster, Inc. Injection catheter with needle electrode
US9254123B2 (en) 2009-04-29 2016-02-09 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
US10231788B2 (en) 2008-03-27 2019-03-19 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter system
US10357322B2 (en) 2009-07-22 2019-07-23 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method for controlling a remote medical device guidance system in three-dimensions using gestures
US10376672B2 (en) 2013-03-15 2019-08-13 Auris Health, Inc. Catheter insertion system and method of fabrication
US10398518B2 (en) 2014-07-01 2019-09-03 Auris Health, Inc. Articulating flexible endoscopic tool with roll capabilities
US10405940B2 (en) 2013-10-24 2019-09-10 Auris Health, Inc. Endoscopic device with double-helical lumen design
US10426557B2 (en) 2008-03-27 2019-10-01 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method of automatic detection of obstructions for a robotic catheter system
US10463439B2 (en) 2016-08-26 2019-11-05 Auris Health, Inc. Steerable catheter with shaft load distributions
US10493241B2 (en) 2014-07-01 2019-12-03 Auris Health, Inc. Apparatuses and methods for monitoring tendons of steerable catheters
US10555780B2 (en) 2010-09-17 2020-02-11 Auris Health, Inc. Systems and methods for positioning an elongate member inside a body
US10667720B2 (en) 2011-07-29 2020-06-02 Auris Health, Inc. Apparatus and methods for fiber integration and registration
US10716461B2 (en) 2017-05-17 2020-07-21 Auris Health, Inc. Exchangeable working channel
US10791950B2 (en) 2011-09-30 2020-10-06 Biosense Webster (Israel) Ltd. In-vivo calibration of contact force-sensing catheters using auto zero zones
US10792464B2 (en) 2014-07-01 2020-10-06 Auris Health, Inc. Tool and method for using surgical endoscope with spiral lumens
US10898276B2 (en) 2018-08-07 2021-01-26 Auris Health, Inc. Combining strain-based shape sensing with catheter control
US11109920B2 (en) 2018-03-28 2021-09-07 Auris Health, Inc. Medical instruments with variable bending stiffness profiles
US11179212B2 (en) 2018-09-26 2021-11-23 Auris Health, Inc. Articulating medical instruments
US11617627B2 (en) 2019-03-29 2023-04-04 Auris Health, Inc. Systems and methods for optical strain sensing in medical instruments
US11717147B2 (en) 2019-08-15 2023-08-08 Auris Health, Inc. Medical device having multiple bending sections
US11723636B2 (en) 2013-03-08 2023-08-15 Auris Health, Inc. Method, apparatus, and system for facilitating bending of an instrument in a surgical or medical robotic environment
US11819636B2 (en) 2015-03-30 2023-11-21 Auris Health, Inc. Endoscope pull wire electrical circuit

Families Citing this family (431)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030109778A1 (en) * 1997-06-20 2003-06-12 Cardiac Assist Devices, Inc. Electrophysiology/ablation catheter and remote actuator therefor
AU8507698A (en) 1997-07-29 1999-02-22 Ep Technologies Inc Improved catheter distal end assemblies
US6123699A (en) * 1997-09-05 2000-09-26 Cordis Webster, Inc. Omni-directional steerable catheter
FR2768324B1 (en) 1997-09-12 1999-12-10 Jacques Seguin SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER
CA2273467C (en) * 1998-06-04 2009-02-17 Cordis Webster, Inc. Catheter for injecting therapeutic and diagnostic agents
US6544215B1 (en) 1998-10-02 2003-04-08 Scimed Life Systems, Inc. Steerable device for introducing diagnostic and therapeutic apparatus into the body
US7972323B1 (en) 1998-10-02 2011-07-05 Boston Scientific Scimed, Inc. Steerable device for introducing diagnostic and therapeutic apparatus into the body
US20070066972A1 (en) 2001-11-29 2007-03-22 Medwaves, Inc. Ablation catheter apparatus with one or more electrodes
US7070595B2 (en) * 1998-12-14 2006-07-04 Medwaves, Inc. Radio-frequency based catheter system and method for ablating biological tissues
US6374476B1 (en) * 1999-03-03 2002-04-23 Codris Webster, Inc. Method for making a catheter tip section
US20040044350A1 (en) 1999-04-09 2004-03-04 Evalve, Inc. Steerable access sheath and methods of use
AU770243B2 (en) 1999-04-09 2004-02-19 Evalve, Inc. Methods and apparatus for cardiac valve repair
US7811296B2 (en) * 1999-04-09 2010-10-12 Evalve, Inc. Fixation devices for variation in engagement of tissue
US7563267B2 (en) 1999-04-09 2009-07-21 Evalve, Inc. Fixation device and methods for engaging tissue
US6752813B2 (en) 1999-04-09 2004-06-22 Evalve, Inc. Methods and devices for capturing and fixing leaflets in valve repair
US8216256B2 (en) 1999-04-09 2012-07-10 Evalve, Inc. Detachment mechanism for implantable fixation devices
US10327743B2 (en) 1999-04-09 2019-06-25 Evalve, Inc. Device and methods for endoscopic annuloplasty
US6585717B1 (en) 1999-06-15 2003-07-01 Cryocath Technologies Inc. Deflection structure
SE514718C2 (en) * 1999-06-29 2001-04-09 Jan Otto Solem Apparatus for treating defective closure of the mitral valve apparatus
US6997951B2 (en) * 1999-06-30 2006-02-14 Edwards Lifesciences Ag Method and device for treatment of mitral insufficiency
US7192442B2 (en) * 1999-06-30 2007-03-20 Edwards Lifesciences Ag Method and device for treatment of mitral insufficiency
US6829497B2 (en) * 1999-09-21 2004-12-07 Jamil Mogul Steerable diagnostic catheters
US6711428B2 (en) * 2000-01-27 2004-03-23 Biosense Webster, Inc. Catheter having mapping assembly
US6628976B1 (en) * 2000-01-27 2003-09-30 Biosense Webster, Inc. Catheter having mapping assembly
US7570982B2 (en) * 2000-01-27 2009-08-04 Biosense Webster, Inc. Catheter having mapping assembly
US6795721B2 (en) 2000-01-27 2004-09-21 Biosense Webster, Inc. Bidirectional catheter having mapping assembly
US7296577B2 (en) 2000-01-31 2007-11-20 Edwards Lifescience Ag Transluminal mitral annuloplasty with active anchoring
US6402781B1 (en) 2000-01-31 2002-06-11 Mitralife Percutaneous mitral annuloplasty and cardiac reinforcement
US6989028B2 (en) * 2000-01-31 2006-01-24 Edwards Lifesciences Ag Medical system and method for remodeling an extravascular tissue structure
US6491681B1 (en) * 2000-04-06 2002-12-10 Scimed Life Systems, Inc. Handle for use with steerable device for introducing diagnostic and therapeutic elements into the body
US6599265B2 (en) * 2000-07-05 2003-07-29 Visionary Biomedical, Inc. Brake assembly for a steerable cathether
US6726700B1 (en) 2000-08-21 2004-04-27 Counter Clockwise, Inc. Manipulatable delivery catheter for occlusive devices
US6482221B1 (en) 2000-08-21 2002-11-19 Counter Clockwise, Inc. Manipulatable delivery catheter for occlusive devices (II)
US6805675B1 (en) * 2000-09-12 2004-10-19 Medtronic, Inc. Method and apparatus for deflecting a screw-in lead
US6926669B1 (en) * 2000-10-10 2005-08-09 Medtronic, Inc. Heart wall ablation/mapping catheter and method
US7510576B2 (en) 2001-01-30 2009-03-31 Edwards Lifesciences Ag Transluminal mitral annuloplasty
US20020169444A1 (en) 2001-05-08 2002-11-14 Mest Robert A. Catheter having continuous braided electrode
US20030208219A1 (en) * 2001-05-18 2003-11-06 Aznoian Harold M. Steerable biliary catheter
US6575971B2 (en) 2001-11-15 2003-06-10 Quantum Cor, Inc. Cardiac valve leaflet stapler device and methods thereof
WO2003047448A1 (en) * 2001-11-29 2003-06-12 Medwaves, Inc. Radio-frequency-based catheter system with improved deflection and steering mechanisms
AU2002360066B2 (en) * 2001-12-28 2008-11-06 Edwards Lifesciences Ag Delayed memory device
SE524709C2 (en) * 2002-01-11 2004-09-21 Edwards Lifesciences Ag Device for delayed reshaping of a heart vessel and a heart valve
US6733499B2 (en) 2002-02-28 2004-05-11 Biosense Webster, Inc. Catheter having circular ablation assembly
US7048754B2 (en) 2002-03-01 2006-05-23 Evalve, Inc. Suture fasteners and methods of use
US7588568B2 (en) * 2002-07-19 2009-09-15 Biosense Webster, Inc. Atrial ablation catheter and method for treating atrial fibrillation
US7560269B2 (en) * 2002-12-20 2009-07-14 Acea Biosciences, Inc. Real time electronic cell sensing system and applications for cytotoxicity profiling and compound assays
US7004937B2 (en) * 2002-07-31 2006-02-28 Cryocor, Inc. Wire reinforced articulation segment
US20040034365A1 (en) * 2002-08-16 2004-02-19 Lentz David J. Catheter having articulation system
US7594903B2 (en) * 2002-09-25 2009-09-29 Abbott Cardiovascular Systems Inc. Controlling shaft bending moment and whipping in a tendon deflection or other tendon system
US7087064B1 (en) 2002-10-15 2006-08-08 Advanced Cardiovascular Systems, Inc. Apparatuses and methods for heart valve repair
US6976979B2 (en) * 2002-10-31 2005-12-20 Medtronic, Inc. Malleable cannula
US8187324B2 (en) 2002-11-15 2012-05-29 Advanced Cardiovascular Systems, Inc. Telescoping apparatus for delivering and adjusting a medical device in a vessel
US6945978B1 (en) 2002-11-15 2005-09-20 Advanced Cardiovascular Systems, Inc. Heart valve catheter
US20050165366A1 (en) 2004-01-28 2005-07-28 Brustad John R. Medical tubing having variable characteristics and method of making same
US7981152B1 (en) 2004-12-10 2011-07-19 Advanced Cardiovascular Systems, Inc. Vascular delivery system for accessing and delivering devices into coronary sinus and other vascular sites
US7335213B1 (en) 2002-11-15 2008-02-26 Abbott Cardiovascular Systems Inc. Apparatus and methods for heart valve repair
US20050004515A1 (en) 2002-11-15 2005-01-06 Hart Charles C. Steerable kink resistant sheath
US7331972B1 (en) 2002-11-15 2008-02-19 Abbott Cardiovascular Systems Inc. Heart valve chord cutter
US20070260225A1 (en) * 2002-11-15 2007-11-08 Applied Medical Resources Corporation Steerable sheath actuator
US7485143B2 (en) 2002-11-15 2009-02-03 Abbott Cardiovascular Systems Inc. Apparatuses and methods for heart valve repair
US9149602B2 (en) 2005-04-22 2015-10-06 Advanced Cardiovascular Systems, Inc. Dual needle delivery system
US20060064054A1 (en) * 2002-11-15 2006-03-23 Applied Medical Resources Corporation Longitudinal sheath enforcement
US7404824B1 (en) 2002-11-15 2008-07-29 Advanced Cardiovascular Systems, Inc. Valve aptation assist device
US7819866B2 (en) 2003-01-21 2010-10-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation catheter and electrode
US7120502B2 (en) * 2003-02-21 2006-10-10 Medtronic, Inc. Shaft constructions for a medical device
US8256428B2 (en) * 2003-03-12 2012-09-04 Biosense Webster, Inc. Method for treating tissue
US6987995B2 (en) * 2003-03-12 2006-01-17 Biosense Webster, Inc. Multifunctional catheter handle
US7276062B2 (en) 2003-03-12 2007-10-02 Biosence Webster, Inc. Deflectable catheter with hinge
US7142903B2 (en) * 2003-03-12 2006-11-28 Biosense Webster, Inc. Catheter with contractable mapping assembly
US10667823B2 (en) 2003-05-19 2020-06-02 Evalve, Inc. Fixation devices, systems and methods for engaging tissue
JP4598410B2 (en) * 2003-05-27 2010-12-15 オリンパス株式会社 Endoscope
US7056314B1 (en) 2003-05-30 2006-06-06 Pacesetter, Inc. Steerable obturator
US7163537B2 (en) * 2003-06-02 2007-01-16 Biosense Webster, Inc. Enhanced ablation and mapping catheter and method for treating atrial fibrillation
US7540853B2 (en) * 2003-06-30 2009-06-02 Cardiac Pacemakers, Inc. Method and apparatus for diverting blood flow during ablation procedures
US7235070B2 (en) * 2003-07-02 2007-06-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation fluid manifold for ablation catheter
US7101362B2 (en) * 2003-07-02 2006-09-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Steerable and shapable catheter employing fluid force
US7678104B2 (en) 2003-07-17 2010-03-16 Biosense Webster, Inc. Ultrasound ablation catheter and method for its use
EP1646332B1 (en) * 2003-07-18 2015-06-17 Edwards Lifesciences AG Remotely activated mitral annuloplasty system
US10182734B2 (en) 2003-07-18 2019-01-22 Biosense Webster, Inc. Enhanced ablation and mapping catheter and method for treating atrial fibrillation
US6926711B2 (en) * 2003-07-30 2005-08-09 Cryocor, Inc. Articulating catheter for cryoablation with reduced diameter section
ITRM20030376A1 (en) 2003-07-31 2005-02-01 Univ Roma PROCEDURE FOR THE ISOLATION AND EXPANSION OF CARDIOC STAMIN CELLS FROM BIOPSIA.
US7998112B2 (en) * 2003-09-30 2011-08-16 Abbott Cardiovascular Systems Inc. Deflectable catheter assembly and method of making same
US7591813B2 (en) * 2003-10-01 2009-09-22 Micrus Endovascular Corporation Long nose manipulatable catheter
US8414524B2 (en) * 2003-10-01 2013-04-09 Micrus Endovascular Corporation Long nose manipulatable catheter
US7207989B2 (en) * 2003-10-27 2007-04-24 Biosense Webster, Inc. Method for ablating with needle electrode
US7366557B2 (en) * 2003-11-07 2008-04-29 Biosense Webster, Inc. Flower catheter
US20050119644A1 (en) * 2003-12-01 2005-06-02 Koerner Richard J. Articulating catheter tip with wedge-cuts
US7481793B2 (en) * 2003-12-10 2009-01-27 Boston Scientic Scimed, Inc. Modular steerable sheath catheters
US20050177228A1 (en) * 2003-12-16 2005-08-11 Solem Jan O. Device for changing the shape of the mitral annulus
US7553323B1 (en) 2004-01-08 2009-06-30 Perez Juan I Steerable endovascular graft delivery system
US7637903B2 (en) * 2004-02-09 2009-12-29 Cryocor, Inc. Catheter articulation segment with alternating cuts
US20050177131A1 (en) * 2004-02-09 2005-08-11 Lentz David J. Catheter articulation segment with alternating cuts
US8046049B2 (en) * 2004-02-23 2011-10-25 Biosense Webster, Inc. Robotically guided catheter
US8007495B2 (en) 2004-03-31 2011-08-30 Biosense Webster, Inc. Catheter for circumferential ablation at or near a pulmonary vein
US8262653B2 (en) * 2004-04-02 2012-09-11 Biosense Webster, Inc. Irrigated catheter having a porous tip electrode
US7993397B2 (en) 2004-04-05 2011-08-09 Edwards Lifesciences Ag Remotely adjustable coronary sinus implant
EP1750592B1 (en) 2004-05-14 2016-12-28 Evalve, Inc. Locking mechanisms for fixation devices
US8007462B2 (en) * 2004-05-17 2011-08-30 C. R. Bard, Inc. Articulated catheter
US8755864B2 (en) 2004-05-28 2014-06-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for diagnostic data mapping
US10863945B2 (en) 2004-05-28 2020-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system with contact sensing feature
US9782130B2 (en) 2004-05-28 2017-10-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system
US8528565B2 (en) 2004-05-28 2013-09-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated therapy delivery
US7632265B2 (en) 2004-05-28 2009-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Radio frequency ablation servo catheter and method
US10258285B2 (en) 2004-05-28 2019-04-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated creation of ablation lesions
US7974674B2 (en) 2004-05-28 2011-07-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for surface modeling
US20050283179A1 (en) * 2004-06-17 2005-12-22 Lentz David J Introducer sheath
US7285108B2 (en) * 2004-06-24 2007-10-23 Cryocor, Inc. Active system for deflecting a distal portion of a catheter into a hoop configuration
US7374553B2 (en) * 2004-06-24 2008-05-20 Cryocor, Inc. System for bi-directionally controlling the cryo-tip of a cryoablation catheter
US7357797B2 (en) * 2004-06-30 2008-04-15 Cryocor, Inc. System and method for varying return pressure to control tip temperature of a cryoablation catheter
US7717875B2 (en) * 2004-07-20 2010-05-18 St. Jude Medical, Atrial Fibrillation Division, Inc. Steerable catheter with hydraulic or pneumatic actuator
US20060047245A1 (en) * 2004-08-24 2006-03-02 Ruchir Sehra Catheter control unit
US8052592B2 (en) 2005-09-27 2011-11-08 Evalve, Inc. Methods and devices for tissue grasping and assessment
US7635329B2 (en) 2004-09-27 2009-12-22 Evalve, Inc. Methods and devices for tissue grasping and assessment
US8070693B2 (en) * 2004-09-30 2011-12-06 Cook Medical Technologies Llc Articulating steerable wire guide
US20060089637A1 (en) 2004-10-14 2006-04-27 Werneth Randell L Ablation catheter
US20060084939A1 (en) * 2004-10-20 2006-04-20 Lentz David J Articulation segment for a catheter
US11660317B2 (en) 2004-11-08 2023-05-30 The Johns Hopkins University Compositions comprising cardiosphere-derived cells for use in cell therapy
US8617152B2 (en) 2004-11-15 2013-12-31 Medtronic Ablation Frontiers Llc Ablation system with feedback
US7429261B2 (en) 2004-11-24 2008-09-30 Ablation Frontiers, Inc. Atrial ablation catheter and method of use
US7468062B2 (en) 2004-11-24 2008-12-23 Ablation Frontiers, Inc. Atrial ablation catheter adapted for treatment of septal wall arrhythmogenic foci and method of use
US7211110B2 (en) 2004-12-09 2007-05-01 Edwards Lifesciences Corporation Diagnostic kit to assist with heart valve annulus adjustment
US8858495B2 (en) 2004-12-28 2014-10-14 St. Jude Medical, Atrial Fibrillation Division, Inc. Five degree of freedom ultrasound catheter and catheter control handle
US8583260B2 (en) 2004-12-28 2013-11-12 St. Jude Medical, Atrial Fibrillation Division, Inc. Long travel steerable catheter actuator
US7691095B2 (en) 2004-12-28 2010-04-06 St. Jude Medical, Atrial Fibrillation Division, Inc. Bi-directional steerable catheter control handle
EP3967269A3 (en) 2005-02-07 2022-07-13 Evalve, Inc. Systems and devices for cardiac valve repair
US8470028B2 (en) 2005-02-07 2013-06-25 Evalve, Inc. Methods, systems and devices for cardiac valve repair
US7959601B2 (en) 2005-02-14 2011-06-14 Biosense Webster, Inc. Steerable catheter with in-plane deflection
US7591784B2 (en) 2005-04-26 2009-09-22 St. Jude Medical, Atrial Fibrillation Division, Inc. Bi-directional handle for a catheter
US8376990B2 (en) * 2005-05-19 2013-02-19 Biosense Webster, Inc. Steerable catheter with distal tip orientation sheaths
US8155910B2 (en) 2005-05-27 2012-04-10 St. Jude Medical, Atrial Fibrillation Divison, Inc. Robotically controlled catheter and method of its calibration
US20060270975A1 (en) * 2005-05-31 2006-11-30 Prorhythm, Inc. Steerable catheter
US20060270976A1 (en) * 2005-05-31 2006-11-30 Prorhythm, Inc. Steerable catheter
US7500989B2 (en) * 2005-06-03 2009-03-10 Edwards Lifesciences Corp. Devices and methods for percutaneous repair of the mitral valve via the coronary sinus
US7553305B2 (en) * 2005-06-09 2009-06-30 Enpath Medical, Inc. Push-pull wire anchor
AU2006262447A1 (en) 2005-06-20 2007-01-04 Medtronic Ablation Frontiers Llc Ablation catheter
US7819868B2 (en) 2005-06-21 2010-10-26 St. Jude Medical, Atrial Fibrilation Division, Inc. Ablation catheter with fluid distribution structures
US8777929B2 (en) 2005-06-28 2014-07-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Auto lock for catheter handle
US7465288B2 (en) 2005-06-28 2008-12-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Actuation handle for a catheter
JP2007018615A (en) * 2005-07-08 2007-01-25 Sony Corp Storage device and semiconductor device
US8834461B2 (en) 2005-07-11 2014-09-16 Medtronic Ablation Frontiers Llc Low power tissue ablation system
US20080221673A1 (en) * 2005-08-12 2008-09-11 Donald Bobo Medical implant with reinforcement mechanism
US20070038297A1 (en) * 2005-08-12 2007-02-15 Bobo Donald E Jr Medical implant with reinforcement mechanism
US8657814B2 (en) 2005-08-22 2014-02-25 Medtronic Ablation Frontiers Llc User interface for tissue ablation system
US20070060997A1 (en) * 2005-09-15 2007-03-15 Jan De Boer Multi-lumen steerable catheter
US9445784B2 (en) 2005-09-22 2016-09-20 Boston Scientific Scimed, Inc Intravascular ultrasound catheter
US20070073391A1 (en) * 2005-09-28 2007-03-29 Henry Bourang System and method for delivering a mitral valve repair device
CA2628417C (en) * 2005-11-08 2014-07-08 Custom Medical Applications, Inc. Reinforced catheter with articulated distal tip
US20070173926A1 (en) * 2005-12-09 2007-07-26 Bobo Donald E Jr Anchoring system for medical implant
US8066664B2 (en) * 2005-12-12 2011-11-29 Taheri Laduca Llc Tri-directional articulating catheter
WO2007081706A2 (en) 2006-01-09 2007-07-19 Vance Products Incorporated, D/B/A Cook Urological Incorporated Deflectable tip access sheath
US7637946B2 (en) 2006-02-09 2009-12-29 Edwards Lifesciences Corporation Coiled implant for mitral valve repair
US9138250B2 (en) 2006-04-24 2015-09-22 Ethicon Endo-Surgery, Inc. Medical instrument handle and medical instrument having a handle
US20070270679A1 (en) 2006-05-17 2007-11-22 Duy Nguyen Deflectable variable radius catheters
EP2018336B1 (en) 2006-05-18 2018-08-22 Applied Medical Resources Corporation Method of making medical tubing having variable characteristics using thermal winding
EP2021063B1 (en) 2006-05-19 2013-05-15 Boston Scientific Limited Control mechanism for steerable medical device
US8328752B2 (en) * 2006-06-30 2012-12-11 Cvdevices, Llc Devices, systems, and methods for promotion of infarct healing and reinforcement of border zone
AU2007275844B2 (en) * 2006-06-30 2013-05-23 Cvdevices, Llc Percutaneous intravascular access to cardiac tissue
US9023075B2 (en) * 2006-06-30 2015-05-05 Cvdevices, Llc Devices, systems, and methods for lead delivery
US8211084B2 (en) * 2006-06-30 2012-07-03 Cvdevices, Llc Devices, systems, and methods for accessing the epicardial surface of the heart
US8715205B2 (en) 2006-08-25 2014-05-06 Cook Medical Tecnologies Llc Loop tip wire guide
US20080058765A1 (en) * 2006-08-31 2008-03-06 Pierri Jais Catheter for linear and circular mapping
US20080065205A1 (en) * 2006-09-11 2008-03-13 Duy Nguyen Retrievable implant and method for treatment of mitral regurgitation
JP4877547B2 (en) * 2006-09-14 2012-02-15 有限会社リバー精工 Cardiac catheter
US8109883B2 (en) * 2006-09-28 2012-02-07 Tyco Healthcare Group Lp Cable monitoring apparatus
US7731706B2 (en) * 2006-12-29 2010-06-08 St. Jude Medical, Atrial Fibrillation Division, Inc. True angular catheter shaft deflection apparatus
US8444637B2 (en) * 2006-12-29 2013-05-21 St. Jude Medical, Atrial Filbrillation Division, Inc. Steerable ablation device
WO2008087646A2 (en) * 2007-01-17 2008-07-24 G.I. View Ltd. Diagnostic or treatment tool for colonoscopy
US8571662B2 (en) 2007-01-29 2013-10-29 Simon Fraser University Transvascular nerve stimulation apparatus and methods
US9089339B2 (en) * 2007-04-04 2015-07-28 Biosense Webster, Inc. Electrophysiology catheter with improved tip electrode
US20080255447A1 (en) * 2007-04-16 2008-10-16 Henry Bourang Diagnostic catheter
US8540674B2 (en) 2007-04-27 2013-09-24 Cvdevices, Llc Devices, systems, and methods for transeptal atrial puncture using an engagement catheter platform
US9050064B2 (en) * 2007-04-27 2015-06-09 Cvdevices, Llc Systems for engaging a bodily tissue and methods of using the same
JP5174891B2 (en) * 2007-04-27 2013-04-03 シーヴィ デヴァイシズ,エルエルシー Devices, systems, and methods for accessing the epicardial surface of the heart
US8588885B2 (en) 2007-05-09 2013-11-19 St. Jude Medical, Atrial Fibrillation Division, Inc. Bendable catheter arms having varied flexibility
US8641704B2 (en) 2007-05-11 2014-02-04 Medtronic Ablation Frontiers Llc Ablation therapy system and method for treating continuous atrial fibrillation
US8192399B2 (en) * 2007-05-23 2012-06-05 Biosense Webster, Inc. Extension control handle with adjustable locking mechanism
US8603046B2 (en) * 2007-05-23 2013-12-10 Biosense Webster, Inc. Automated injection catheter device and system
US8480653B2 (en) * 2007-05-23 2013-07-09 Biosense Webster, Inc. Magnetically guided catheter with concentric needle port
US8100820B2 (en) 2007-08-22 2012-01-24 Edwards Lifesciences Corporation Implantable device for treatment of ventricular dilation
US20090088652A1 (en) * 2007-09-28 2009-04-02 Kathleen Tremblay Physiological sensor placement and signal transmission device
US8535308B2 (en) 2007-10-08 2013-09-17 Biosense Webster (Israel), Ltd. High-sensitivity pressure-sensing probe
US8357152B2 (en) 2007-10-08 2013-01-22 Biosense Webster (Israel), Ltd. Catheter with pressure sensing
US8197464B2 (en) * 2007-10-19 2012-06-12 Cordis Corporation Deflecting guide catheter for use in a minimally invasive medical procedure for the treatment of mitral valve regurgitation
US8137336B2 (en) 2008-06-27 2012-03-20 Boston Scientific Scimed, Inc. Steerable medical device
US20090299352A1 (en) * 2007-12-21 2009-12-03 Boston Scientific Scimed, Inc. Steerable laser-energy delivery device
US7780648B2 (en) 2007-12-28 2010-08-24 Boston Scientific Scimed, Inc. Controlling movement of distal portion of medical device
EP2249691B1 (en) * 2008-01-24 2013-07-03 Boston Scientific Scimed, Inc. Structure for use as part of a medical device
NZ587007A (en) * 2008-02-05 2013-03-28 Cvdevices Llc Steering engagement catheter devices, systems and methods
US8048024B2 (en) 2008-03-17 2011-11-01 Boston Scientific Scimed, Inc. Steering mechanism
US8317744B2 (en) 2008-03-27 2012-11-27 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter manipulator assembly
US20090248042A1 (en) * 2008-03-27 2009-10-01 Kirschenman Mark B Model catheter input device
US8317745B2 (en) * 2008-03-27 2012-11-27 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter rotatable device cartridge
WO2009120982A2 (en) 2008-03-27 2009-10-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter system with dynamic response
US9241768B2 (en) 2008-03-27 2016-01-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Intelligent input device controller for a robotic catheter system
WO2009120992A2 (en) * 2008-03-27 2009-10-01 St. Jude Medical, Arrial Fibrillation Division Inc. Robotic castheter system input device
US8437832B2 (en) 2008-06-06 2013-05-07 Biosense Webster, Inc. Catheter with bendable tip
US9101735B2 (en) * 2008-07-07 2015-08-11 Intuitive Surgical Operations, Inc. Catheter control systems
US8048025B2 (en) * 2008-07-07 2011-11-01 Boston Scientific Scimed, Inc. Multi-plane motion control mechanism
US9101734B2 (en) 2008-09-09 2015-08-11 Biosense Webster, Inc. Force-sensing catheter with bonded center strut
US8118775B2 (en) 2008-09-09 2012-02-21 Biosense Webster, Inc. Deflectable catheter with bonded center strut and method of manufacture for same
AU2013203884B2 (en) * 2008-09-09 2015-07-02 Biosense Webster, Inc. Deflectable catheter with bonded center strut and method of manufacture for same
US20100087780A1 (en) * 2008-10-03 2010-04-08 Cook Incorporated Wire Guide having Variable Flexibility and Method of Use Thereof
US8834357B2 (en) 2008-11-12 2014-09-16 Boston Scientific Scimed, Inc. Steering mechanism
US9326700B2 (en) 2008-12-23 2016-05-03 Biosense Webster (Israel) Ltd. Catheter display showing tip angle and pressure
US9339331B2 (en) 2008-12-29 2016-05-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Non-contact electrode basket catheters with irrigation
US10058382B2 (en) 2008-12-30 2018-08-28 Biosense Webster, Inc. Catheter with protective barrier member
US8712550B2 (en) * 2008-12-30 2014-04-29 Biosense Webster, Inc. Catheter with multiple electrode assemblies for use at or near tubular regions of the heart
US8600472B2 (en) 2008-12-30 2013-12-03 Biosense Webster (Israel), Ltd. Dual-purpose lasso catheter with irrigation using circumferentially arranged ring bump electrodes
US8475450B2 (en) 2008-12-30 2013-07-02 Biosense Webster, Inc. Dual-purpose lasso catheter with irrigation
US20100168717A1 (en) 2008-12-30 2010-07-01 Grasse Martin M Multi-lumen medical devices and methods of manufacturing same
US20110238010A1 (en) * 2008-12-31 2011-09-29 Kirschenman Mark B Robotic catheter system input device
US8123721B2 (en) * 2008-12-31 2012-02-28 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter having independently-deflectable segments and method of its manufacture
US8556850B2 (en) 2008-12-31 2013-10-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Shaft and handle for a catheter with independently-deflectable segments
US8808345B2 (en) 2008-12-31 2014-08-19 Medtronic Ardian Luxembourg S.A.R.L. Handle assemblies for intravascular treatment devices and associated systems and methods
US8372033B2 (en) * 2008-12-31 2013-02-12 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter having proximal heat sensitive deflection mechanism and related methods of use and manufacturing
US8676290B2 (en) * 2010-05-11 2014-03-18 St. Jude Medical, Atrial Fibrillation Division, Inc. Multi-directional catheter control handle
US8758231B2 (en) 2009-05-14 2014-06-24 Cook Medical Technologies Llc Access sheath with active deflection
US9330497B2 (en) 2011-08-12 2016-05-03 St. Jude Medical, Atrial Fibrillation Division, Inc. User interface devices for electrophysiology lab diagnostic and therapeutic equipment
US8747351B2 (en) 2009-08-28 2014-06-10 Biosense Webster, Inc. Catheter with multi-functional control handle having linear mechanism
US9033916B2 (en) 2009-08-28 2015-05-19 Biosense Webster, Inc. Catheter with multi-functional control handle having rotational mechanism
EP2633821B1 (en) 2009-09-15 2016-04-06 Evalve, Inc. Device for cardiac valve repair
US9101733B2 (en) 2009-09-29 2015-08-11 Biosense Webster, Inc. Catheter with biased planar deflection
US10688278B2 (en) * 2009-11-30 2020-06-23 Biosense Webster (Israel), Ltd. Catheter with pressure measuring tip
US8920415B2 (en) 2009-12-16 2014-12-30 Biosense Webster (Israel) Ltd. Catheter with helical electrode
US8521462B2 (en) 2009-12-23 2013-08-27 Biosense Webster (Israel), Ltd. Calibration system for a pressure-sensitive catheter
US8529476B2 (en) 2009-12-28 2013-09-10 Biosense Webster (Israel), Ltd. Catheter with strain gauge sensor
US8608735B2 (en) * 2009-12-30 2013-12-17 Biosense Webster (Israel) Ltd. Catheter with arcuate end section
US8374670B2 (en) 2010-01-22 2013-02-12 Biosense Webster, Inc. Catheter having a force sensing distal tip
JP5265589B2 (en) * 2010-01-23 2013-08-14 日本ライフライン株式会社 Electrode catheter
WO2011089750A1 (en) * 2010-01-23 2011-07-28 日本ライフライン株式会社 Electrode catheter
US20110224647A1 (en) * 2010-03-11 2011-09-15 Lazarus Harrison M Body cavity drainage devices and related methods
US10232150B2 (en) 2010-03-11 2019-03-19 Merit Medical Systems, Inc. Body cavity drainage devices and related methods
US20110224720A1 (en) * 2010-03-11 2011-09-15 Cvdevices, Llc Devices, systems, and methods for closing a hole in cardiac tissue
EP2542296A4 (en) 2010-03-31 2014-11-26 St Jude Medical Atrial Fibrill Intuitive user interface control for remote catheter navigation and 3d mapping and visualization systems
US8906013B2 (en) 2010-04-09 2014-12-09 Endosense Sa Control handle for a contact force ablation catheter
US9795765B2 (en) 2010-04-09 2017-10-24 St. Jude Medical International Holding S.À R.L. Variable stiffness steering mechanism for catheters
US9845457B2 (en) 2010-04-30 2017-12-19 Cedars-Sinai Medical Center Maintenance of genomic stability in cultured stem cells
US9249392B2 (en) 2010-04-30 2016-02-02 Cedars-Sinai Medical Center Methods and compositions for maintaining genomic stability in cultured stem cells
US9289147B2 (en) 2010-05-11 2016-03-22 St. Jude Medical, Atrial Fibrillation Division, Inc. Multi-directional flexible wire harness for medical devices
US8798952B2 (en) 2010-06-10 2014-08-05 Biosense Webster (Israel) Ltd. Weight-based calibration system for a pressure sensitive catheter
US8226580B2 (en) 2010-06-30 2012-07-24 Biosense Webster (Israel), Ltd. Pressure sensing for a multi-arm catheter
US8380276B2 (en) 2010-08-16 2013-02-19 Biosense Webster, Inc. Catheter with thin film pressure sensing distal tip
US8731859B2 (en) 2010-10-07 2014-05-20 Biosense Webster (Israel) Ltd. Calibration system for a force-sensing catheter
US8794830B2 (en) 2010-10-13 2014-08-05 Biosense Webster, Inc. Catheter with digitized temperature measurement in control handle
US8979772B2 (en) 2010-11-03 2015-03-17 Biosense Webster (Israel), Ltd. Zero-drift detection and correction in contact force measurements
US8986303B2 (en) 2010-11-09 2015-03-24 Biosense Webster, Inc. Catheter with liquid-cooled control handle
US8617087B2 (en) 2010-12-03 2013-12-31 Biosense Webster, Inc. Control handle with rotational cam mechanism for contraction/deflection of medical device
US8792962B2 (en) 2010-12-30 2014-07-29 Biosense Webster, Inc. Catheter with single axial sensors
US8430864B2 (en) * 2011-02-16 2013-04-30 Biosense Webster, Inc. Catheter with multiple deflections
USD726905S1 (en) 2011-05-11 2015-04-14 St. Jude Medical, Atrial Fibrillation Division, Inc. Control handle for a medical device
US8486009B2 (en) * 2011-06-20 2013-07-16 Hue-Teh Shih Systems and methods for steering catheters
US9220433B2 (en) 2011-06-30 2015-12-29 Biosense Webster (Israel), Ltd. Catheter with variable arcuate distal section
US9089631B2 (en) 2011-07-22 2015-07-28 Cook Medical Technologies Llc Irrigation devices adapted to be used with a light source for the identification and treatment of bodily passages
US10743932B2 (en) 2011-07-28 2020-08-18 Biosense Webster (Israel) Ltd. Integrated ablation system using catheter with multiple irrigation lumens
US9662169B2 (en) 2011-07-30 2017-05-30 Biosense Webster (Israel) Ltd. Catheter with flow balancing valve
US9592091B2 (en) 2011-08-30 2017-03-14 Biosense Webster (Israel) Ltd. Ablation catheter for vein anatomies
US10201385B2 (en) 2011-09-01 2019-02-12 Biosense Webster (Israel) Ltd. Catheter adapted for direct tissue contact
US8900228B2 (en) 2011-09-01 2014-12-02 Biosense Webster (Israel) Ltd. Catheter adapted for direct tissue contact and pressure sensing
US8840605B2 (en) 2011-09-02 2014-09-23 Katalyst Surgical, Llc Steerable laser probe
US8945177B2 (en) 2011-09-13 2015-02-03 Abbott Cardiovascular Systems Inc. Gripper pusher mechanism for tissue apposition systems
US9089399B2 (en) 2011-09-17 2015-07-28 Katalyst Surgical, Llc Steerable laser probe
US9480600B2 (en) 2012-06-27 2016-11-01 Katalyst Surgical, Llc Steerable laser probe
US9138350B2 (en) 2011-10-17 2015-09-22 Katalyst Surgical, Llc Steerable laser probe
US9107682B2 (en) 2011-11-03 2015-08-18 Katalyst Surgical, Llc Steerable laser probe
US9375138B2 (en) 2011-11-25 2016-06-28 Cook Medical Technologies Llc Steerable guide member and catheter
US8968277B2 (en) 2011-12-09 2015-03-03 Katalyst Surgical, Llc Steerable laser probe
JP5550150B2 (en) * 2011-12-14 2014-07-16 日本ライフライン株式会社 Tip deflectable catheter
US9757538B2 (en) 2011-12-15 2017-09-12 Imricor Medical Systems, Inc. MRI compatible control handle for steerable sheath with audible, tactile and/or visual means
US9821143B2 (en) 2011-12-15 2017-11-21 Imricor Medical Systems, Inc. Steerable sheath including elastomeric member
US20140135745A1 (en) 2011-12-15 2014-05-15 Imricor Medical Systems, Inc. Mri compatible handle and steerable sheath
US8840607B2 (en) 2011-12-23 2014-09-23 Katalyst Surgical, Llc Steerable laser probe
US9162036B2 (en) * 2011-12-30 2015-10-20 Biosense Webster (Israel), Ltd. Medical device control handle with multiple puller wires
US9687289B2 (en) 2012-01-04 2017-06-27 Biosense Webster (Israel) Ltd. Contact assessment based on phase measurement
EP4070850A1 (en) 2012-03-05 2022-10-12 Lungpacer Medical Inc. Transvascular nerve stimulation apparatus and methods
US9314299B2 (en) 2012-03-21 2016-04-19 Biosense Webster (Israel) Ltd. Flower catheter for mapping and ablating veinous and other tubular locations
US9717554B2 (en) 2012-03-26 2017-08-01 Biosense Webster (Israel) Ltd. Catheter with composite construction
US9039686B2 (en) 2012-04-19 2015-05-26 Katalyst Surgical, Llc Steerable laser probe
US10004877B2 (en) * 2012-05-07 2018-06-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Deflectable catheter shaft section, catheter incorporating same, and method of manufacturing same
US9113995B2 (en) 2012-05-08 2015-08-25 Katalyst Surgical, Llc Steerable laser probe
US8951245B2 (en) 2012-05-09 2015-02-10 Katalyst Surgical, Llc Steerable laser probe
US9717555B2 (en) 2012-05-14 2017-08-01 Biosense Webster (Israel), Ltd. Catheter with helical end section for vessel ablation
US9023019B2 (en) 2012-05-10 2015-05-05 Katalyst Surgical, Llc Steerable laser probe
US9549780B2 (en) 2012-05-13 2017-01-24 Katalyst Surgical, Llc Steerable laser probe
US10639099B2 (en) 2012-05-25 2020-05-05 Biosense Webster (Israel), Ltd. Catheter having a distal section with spring sections for biased deflection
EP2861238A4 (en) 2012-06-05 2016-03-16 Capricor Inc Optimized methods for generation of cardiac stem cells from cardiac tissue and their use in cardiac therapy
US9023020B2 (en) 2012-06-06 2015-05-05 Katalyst Surgical, Llc Steerable laser probe
AU2013280184B2 (en) 2012-06-21 2017-08-24 Lungpacer Medical Inc. Transvascular diaphragm pacing systems and methods of use
US9770296B2 (en) 2012-07-31 2017-09-26 Katalyst Surgical, Llc Steerable laser probe
US9877867B2 (en) 2012-08-01 2018-01-30 Katalyst Surgical, Llc Steerable laser probe
US9233022B2 (en) 2012-08-06 2016-01-12 Katalyst Surgical, Llc Steerable laser probe
US9770298B2 (en) 2012-08-10 2017-09-26 Katalyst Surgical, Llc Steerable laser probe
US9828603B2 (en) 2012-08-13 2017-11-28 Cedars Sinai Medical Center Exosomes and micro-ribonucleic acids for tissue regeneration
US9216060B2 (en) 2012-08-14 2015-12-22 Katalyst Surgical, Llc Steerable laser probe
US9232975B2 (en) 2012-09-05 2016-01-12 Katalyst Surgical, Llc Steerable laser probe
US9226855B2 (en) 2012-09-06 2016-01-05 Katalyst Surgical, Llc Steerable laser probe
US9345542B2 (en) 2012-09-11 2016-05-24 Katalyst Surgical, Llc Steerable laser probe
US9351875B2 (en) 2012-09-12 2016-05-31 Katalyst Surgical, Llc Steerable laser probe
US9226794B2 (en) 2012-09-23 2016-01-05 Katalyst Surgical, Llc Steerable laser probe
US9314593B2 (en) 2012-09-24 2016-04-19 Cook Medical Technologies Llc Medical devices for the identification and treatment of bodily passages
US9216111B2 (en) 2012-09-24 2015-12-22 Katalyst Surgical, Llc Steerable laser probe
US9763830B2 (en) 2012-10-13 2017-09-19 Katalyst Surgical, Llc Steerable laser probe
US9931246B2 (en) 2012-10-17 2018-04-03 Katalyst Surgical, Llc Steerable laser probe
US9233225B2 (en) 2012-11-10 2016-01-12 Curvo Medical, Inc. Coaxial bi-directional catheter
US9549666B2 (en) 2012-11-10 2017-01-24 Curvo Medical, Inc. Coaxial micro-endoscope
US20140148673A1 (en) 2012-11-28 2014-05-29 Hansen Medical, Inc. Method of anchoring pullwire directly articulatable region in catheter
US8894610B2 (en) 2012-11-28 2014-11-25 Hansen Medical, Inc. Catheter having unirail pullwire architecture
US9050010B2 (en) * 2012-12-31 2015-06-09 Biosense Webster (Israel) Ltd. Double loop lasso with single puller wire for bi-directional actuation
US9174023B2 (en) 2013-01-07 2015-11-03 Biosense Webster (Israel) Ltd. Unidirectional catheter control handle with tensioning control
US20140200639A1 (en) 2013-01-16 2014-07-17 Advanced Neuromodulation Systems, Inc. Self-expanding neurostimulation leads having broad multi-electrode arrays
US9895055B2 (en) 2013-02-28 2018-02-20 Cook Medical Technologies Llc Medical devices, systems, and methods for the visualization and treatment of bodily passages
US10688230B2 (en) 2013-03-07 2020-06-23 Circulite, Inc. Malleable cannula
US10080576B2 (en) 2013-03-08 2018-09-25 Auris Health, Inc. Method, apparatus, and a system for facilitating bending of an instrument in a surgical or medical robotic environment
EP3505043B1 (en) 2013-03-11 2020-11-25 Boston Scientific Scimed, Inc. Deflection mechanism
US9855404B2 (en) 2013-05-03 2018-01-02 St. Jude Medical International Holding S.À R.L. Dual bend radii steering catheter
US10213341B2 (en) 2013-07-31 2019-02-26 Katalyst Surgical, Llc Laser probe with a replaceable optic fiber
US9549748B2 (en) 2013-08-01 2017-01-24 Cook Medical Technologies Llc Methods of locating and treating tissue in a wall defining a bodily passage
EP3049005B1 (en) 2013-09-24 2022-08-10 Adagio Medical, Inc. Endovascular near critical fluid based cryoablation catheter
EP3760276B1 (en) 2013-11-22 2023-08-30 Lungpacer Medical Inc. Apparatus for assisted breathing by transvascular nerve stimulation
US20150157405A1 (en) 2013-12-05 2015-06-11 Biosense Webster (Israel) Ltd. Needle catheter utilizing optical spectroscopy for tumor identification and ablation
WO2015089505A2 (en) 2013-12-13 2015-06-18 The Trustees Of The University Of Pennsylvania Coaxial ablation probe and method and system for real-time monitoring of ablation therapy
WO2015095727A2 (en) 2013-12-20 2015-06-25 Barnet Corbin Surgical system and related methods
US10278775B2 (en) 2013-12-31 2019-05-07 Biosense Webster (Israel) Ltd. Catheter utilizing optical spectroscopy for measuring tissue contact area
EP3096835B1 (en) 2014-01-21 2019-08-07 Lungpacer Medical Inc. Systems for optimization of multi-electrode nerve pacing
JP6246383B2 (en) 2014-02-06 2017-12-13 セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド Elongated medical device with chamfered ring electrode and variable shaft
US9937323B2 (en) 2014-02-28 2018-04-10 Cook Medical Technologies Llc Deflectable catheters, systems, and methods for the visualization and treatment of bodily passages
US10390943B2 (en) 2014-03-17 2019-08-27 Evalve, Inc. Double orifice device for transcatheter mitral valve replacement
WO2015153174A1 (en) * 2014-04-02 2015-10-08 Intuitive Surgical Operations, Inc. Devices, systems, and methods using a steerable stylet and flexible needle
US9848943B2 (en) 2014-04-18 2017-12-26 Biosense Webster (Israel) Ltd. Ablation catheter with dedicated fluid paths and needle centering insert
US9468407B2 (en) 2014-05-30 2016-10-18 Biosense Webster (Israel) Ltd. Catheter with distal section having side-by-side loops
US9821097B2 (en) 2014-06-27 2017-11-21 Merit Medical Systems, Inc. Body cavity drainage devices including drainage tubes having inline portions and related methods
US10029036B2 (en) 2014-06-27 2018-07-24 Merit Medical Systems, Inc. Placement tools for body cavity drainage devices and related methods
US9649415B2 (en) 2014-06-27 2017-05-16 Harrison M. Lazarus Surgical kits for body cavity drainage and related methods
US9604033B2 (en) 2014-06-27 2017-03-28 Harrison M. Lazarus Body cavity drainage devices with locking devices and related methods
US10195398B2 (en) 2014-08-13 2019-02-05 Cook Medical Technologies Llc Tension member seal and securing mechanism for medical devices
US10576249B2 (en) * 2014-09-30 2020-03-03 St. Jude Medical Cardiology Division, Inc. Medical device including an actuator restraining assembly
AU2015327812B2 (en) 2014-10-03 2021-04-15 Cedars-Sinai Medical Center Cardiosphere-derived cells and exosomes secreted by such cells in the treatment of muscular dystrophy
US10758302B2 (en) 2014-11-11 2020-09-01 Biosense Webster (Israel) Ltd. Irrigated ablation catheter with sensor array
US9788893B2 (en) 2014-11-20 2017-10-17 Biosense Webster (Israel) Ltd. Catheter with soft distal tip for mapping and ablating tubular region
US9820664B2 (en) 2014-11-20 2017-11-21 Biosense Webster (Israel) Ltd. Catheter with high density electrode spine array
US9724154B2 (en) 2014-11-24 2017-08-08 Biosense Webster (Israel) Ltd. Irrigated ablation catheter with multiple sensors
US10188392B2 (en) 2014-12-19 2019-01-29 Abbott Cardiovascular Systems, Inc. Grasping for tissue repair
US10034707B2 (en) 2014-12-30 2018-07-31 Biosense Webster (Israel) Ltd. Catheter with irrigated tip electrode with porous substrate and high density surface micro-electrodes
JP6514334B2 (en) 2015-01-28 2019-05-15 セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド Thermal mapping catheter
CA2980745C (en) 2015-03-27 2023-10-24 Project Moray, Inc. Articulation systems, devices, and methods for catheters and other uses
US10524912B2 (en) 2015-04-02 2020-01-07 Abbott Cardiovascular Systems, Inc. Tissue fixation devices and methods
US9968776B2 (en) * 2015-04-20 2018-05-15 Pacesetter, Inc. Multiple-cable lead with interrupted cable and crimp configuration
US9433530B1 (en) 2015-04-24 2016-09-06 Katalyst Surgical, Llc Steerable laser probe and methods of use
US10376673B2 (en) 2015-06-19 2019-08-13 Evalve, Inc. Catheter guiding system and methods
US10238494B2 (en) 2015-06-29 2019-03-26 Evalve, Inc. Self-aligning radiopaque ring
US9949656B2 (en) 2015-06-29 2018-04-24 Biosense Webster (Israel) Ltd. Catheter with stacked spine electrode assembly
US10537259B2 (en) 2015-06-29 2020-01-21 Biosense Webster (Israel) Ltd. Catheter having closed loop array with in-plane linear electrode portion
US10575742B2 (en) 2015-06-30 2020-03-03 Biosense Webster (Israel) Ltd. Catheter having closed electrode assembly with spines of uniform length
US10667815B2 (en) 2015-07-21 2020-06-02 Evalve, Inc. Tissue grasping devices and related methods
US10413408B2 (en) 2015-08-06 2019-09-17 Evalve, Inc. Delivery catheter systems, methods, and devices
US10238495B2 (en) 2015-10-09 2019-03-26 Evalve, Inc. Delivery catheter handle and methods of use
CN108289709B (en) 2015-10-21 2022-03-04 圣犹达医疗用品心脏病学部门有限公司 High-density electrode mapping catheter
US10245182B2 (en) 2015-11-14 2019-04-02 Katalyst Surgical, Llc Laser probe with replaceable optic fibers
US10813689B2 (en) 2015-11-25 2020-10-27 Biosense Webster (Israel) Ltd. Ablation catheter with radial force detection
CA3003166A1 (en) 2015-11-25 2017-06-01 Merit Medical Systems, Inc. Steerable sheath catheter and methods of use
US10525233B2 (en) 2015-12-04 2020-01-07 Project Moray, Inc. Input and articulation system for catheters and other uses
US10500373B2 (en) 2015-12-04 2019-12-10 Project Moray, Inc. Lateral articulation anchors for catheters and other uses
US10285752B2 (en) 2015-12-07 2019-05-14 Biosense Webster (Israel) Ltd. Multilayer split ablation electrode
US10136945B2 (en) 2015-12-09 2018-11-27 Biosense Webster (Israel) Ltd. Ablation catheter with light-based contact sensors
US10849521B2 (en) 2015-12-23 2020-12-01 Biosense Webster (Israel) Ltd. Multi-layered catheter shaft construction with embedded single axial sensors, and related methods
US11253551B2 (en) 2016-01-11 2022-02-22 Cedars-Sinai Medical Center Cardiosphere-derived cells and exosomes secreted by such cells in the treatment of heart failure with preserved ejection fraction
US9907480B2 (en) 2016-02-08 2018-03-06 Biosense Webster (Israel) Ltd. Catheter spine assembly with closely-spaced bipole microelectrodes
US10806899B2 (en) 2016-02-17 2020-10-20 Project Moray, Inc. Local contraction of flexible bodies using balloon expansion for extension-contraction catheter articulation and other uses
US10675443B2 (en) 2016-03-07 2020-06-09 St. Jude Medical, Cardiology Division, Inc. Medical device including an actuator restraining assembly
EP3432834B1 (en) 2016-03-25 2021-01-13 Project Moray, Inc. Fluid-actuated sheath displacement and articulation behavior improving systems for catheters
US11420021B2 (en) 2016-03-25 2022-08-23 Project Moray, Inc. Fluid-actuated displacement for catheters, continuum manipulators, and other uses
EP3432820B1 (en) 2016-05-03 2021-04-28 St. Jude Medical, Cardiology Division, Inc. Irrigated high density electrode catheter
WO2017205662A1 (en) 2016-05-26 2017-11-30 Boston Scientific Scimed, Inc. Articulating devices
WO2017210652A1 (en) 2016-06-03 2017-12-07 Cedars-Sinai Medical Center Cdc-derived exosomes for treatment of ventricular tachyarrythmias
US10736632B2 (en) 2016-07-06 2020-08-11 Evalve, Inc. Methods and devices for valve clip excision
US10646113B2 (en) 2016-09-09 2020-05-12 Katalyst Surgical, Llc Illuminated cannula
US10420460B2 (en) 2016-09-09 2019-09-24 Katalyst Surgical, Llc Illumination probe
JP6719022B2 (en) * 2016-09-18 2020-07-08 セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド Loop catheter having a manipulation tether coupled to a preformed loop structure
US10709504B2 (en) 2016-09-19 2020-07-14 Katalyst Surgical, Llc Curved laser probe with single-use optic fiber
US11541078B2 (en) 2016-09-20 2023-01-03 Cedars-Sinai Medical Center Cardiosphere-derived cells and their extracellular vesicles to retard or reverse aging and age-related disorders
EP3518806A4 (en) 2016-09-28 2020-06-17 Project Moray, Inc. Arrhythmia diagnostic and/or therapy delivery methods and devices, and robotic systems for other uses
CN109996490B (en) 2016-09-28 2023-01-10 项目莫里股份有限公司 Base station, charging station and/or server for robotic catheter systems and other uses, and improved articulation apparatus and systems
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
US11172858B2 (en) 2016-10-28 2021-11-16 St. Jude Medical, Cardiology Division, Inc. Flexible high-density mapping catheter
US10363138B2 (en) 2016-11-09 2019-07-30 Evalve, Inc. Devices for adjusting the curvature of cardiac valve structures
US10398553B2 (en) 2016-11-11 2019-09-03 Evalve, Inc. Opposing disk device for grasping cardiac valve tissue
US10426616B2 (en) 2016-11-17 2019-10-01 Evalve, Inc. Cardiac implant delivery system
US10779837B2 (en) 2016-12-08 2020-09-22 Evalve, Inc. Adjustable arm device for grasping tissues
US10314586B2 (en) 2016-12-13 2019-06-11 Evalve, Inc. Rotatable device and method for fixing tricuspid valve tissue
KR101821183B1 (en) 2016-12-23 2018-03-08 한국과학기술연구원 Medical device having steerable catheter
US10828091B2 (en) 2016-12-28 2020-11-10 Biosense Webster (Israel) Ltd. Catheter with tapered support member for variable arcuate distal assembly
US10786651B2 (en) 2017-03-07 2020-09-29 Talon Medical, LLC Steerable guide catheter
US10850108B2 (en) * 2017-03-08 2020-12-01 Pacesetter, Inc. Coronary sinus-anchored sheath for delivery of his bundle pacing lead
US10918832B2 (en) 2017-03-27 2021-02-16 Biosense Webster (Israel) Ltd Catheter with improved loop contraction and greater contraction displacement
WO2018195210A1 (en) 2017-04-19 2018-10-25 Cedars-Sinai Medical Center Methods and compositions for treating skeletal muscular dystrophy
US10905861B2 (en) 2017-04-25 2021-02-02 Project Moray, Inc. Matrix supported balloon articulation systems, devices, and methods for catheters and other uses
US11065119B2 (en) 2017-05-12 2021-07-20 Evalve, Inc. Long arm valve repair clip
US10293164B2 (en) 2017-05-26 2019-05-21 Lungpacer Medical Inc. Apparatus and methods for assisted breathing by transvascular nerve stimulation
US20190001126A1 (en) 2017-06-30 2019-01-03 Lungpacer Medical Inc. Devices and methods for prevention, moderation, and/or treatment of cognitive injury
US11433220B2 (en) 2017-07-07 2022-09-06 St. Jude Medical, Cardiology Division, Inc. Layered high density electrode mapping catheter
US11647935B2 (en) 2017-07-24 2023-05-16 St. Jude Medical, Cardiology Division, Inc. Masked ring electrodes
US10195429B1 (en) 2017-08-02 2019-02-05 Lungpacer Medical Inc. Systems and methods for intravascular catheter positioning and/or nerve stimulation
US10940308B2 (en) 2017-08-04 2021-03-09 Lungpacer Medical Inc. Systems and methods for trans-esophageal sympathetic ganglion recruitment
US11564725B2 (en) 2017-09-05 2023-01-31 Adagio Medical, Inc. Ablation catheter having a shape memory stylet
US10702178B2 (en) 2017-10-13 2020-07-07 St. Jude Medical, Cardiology Division, Inc. Catheter with high-density mapping electrodes
US10532187B2 (en) * 2017-10-17 2020-01-14 Biosense Webster (Israel) Ltd. Reusable catheter handle system
US11660355B2 (en) 2017-12-20 2023-05-30 Cedars-Sinai Medical Center Engineered extracellular vesicles for enhanced tissue delivery
US10801899B2 (en) 2018-01-10 2020-10-13 Biosense Webster (Israel) Ltd. Position-biasing thermocouple
US11054315B2 (en) 2018-01-10 2021-07-06 Biosense Webster (Israel) Ltd. Thermally isolated thermocouple
CA3087772A1 (en) 2018-01-10 2019-07-18 Adagio Medical, Inc. Cryoablation element with conductive liner
US10876902B2 (en) 2018-01-10 2020-12-29 Biosense Webster (Israel) Ltd. Position-controlled thermocouple
US10905347B2 (en) * 2018-02-06 2021-02-02 Biosense Webster (Israel) Ltd. Catheter with increased electrode density spine assembly having reinforced spine covers
EP3552552A1 (en) * 2018-04-13 2019-10-16 Koninklijke Philips N.V. Steerable catheter with piezoelectric transducer
US11233369B2 (en) 2018-03-06 2022-01-25 Biosense Webster (Israel) Ltd. Positioning cartridge for electrode
JP2021517486A (en) 2018-03-13 2021-07-26 セント・ジュード・メディカル,カーディオロジー・ディヴィジョン,インコーポレイテッド Variable density mapping catheter
US11471190B2 (en) * 2018-04-02 2022-10-18 Cardiac Pacemakers, Inc. Bundle of his lead delivery catheter, system and method
US11559662B2 (en) 2018-04-13 2023-01-24 Merit Medical Systems, Inc. Steerable drainage devices
US11864825B2 (en) 2018-05-02 2024-01-09 Biosense Webster (Israel) Ltd. Ablation catheter with selective radial energy delivery
WO2020039392A2 (en) 2018-08-23 2020-02-27 St. Jude Medical, Cardiology Division, Inc. Curved high density electrode mapping catheter
EP3877043A4 (en) 2018-11-08 2022-08-24 Lungpacer Medical Inc. Stimulation systems and related user interfaces
WO2020188351A1 (en) 2019-03-18 2020-09-24 Biosense Webster ( Israel) Ltd. ELECTRODE CONFIGURATIONS FOR DIAGNOSIS OF ARRHYTHMlAS
US11850051B2 (en) 2019-04-30 2023-12-26 Biosense Webster (Israel) Ltd. Mapping grid with high density electrode array
US11357979B2 (en) 2019-05-16 2022-06-14 Lungpacer Medical Inc. Systems and methods for sensing and stimulation
WO2020252037A1 (en) 2019-06-12 2020-12-17 Lungpacer Medical Inc. Circuitry for medical stimulation systems
US11471650B2 (en) 2019-09-20 2022-10-18 Biosense Webster (Israel) Ltd. Mechanism for manipulating a puller wire
CN111352512B (en) * 2020-03-04 2021-07-06 深圳市鸿合创新信息技术有限责任公司 Passive capacitance pen and pen point structure thereof
EP3909634B1 (en) * 2020-05-01 2023-07-19 Cook Medical Technologies LLC Deflectable catheter systems
CN113796868A (en) 2020-05-29 2021-12-17 伯恩森斯韦伯斯特(以色列)有限责任公司 Intraluminal reference electrode for cardiovascular therapy device
CN114271924B (en) * 2020-09-27 2024-03-01 四川锦江电子医疗器械科技股份有限公司 Catheter calibration method and device based on grid partition
US11872357B2 (en) 2020-11-09 2024-01-16 Agile Devices, Inc. Devices for steering catheters
CN113350660B (en) * 2021-07-20 2023-06-09 苏州赛纳思医疗科技有限公司 Catheter assembly
US20230210433A1 (en) 2021-12-31 2023-07-06 Biosense Webster (Israel) Ltd. Reconfigurable electrode apparatus for diagnosis of arrhythmias

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3470876A (en) * 1966-09-28 1969-10-07 John Barchilon Dirigible catheter
EP0415553A1 (en) * 1989-07-31 1991-03-06 Kabushiki Kaisha Machida Seisakusho Bending device
EP0616794A1 (en) * 1993-03-12 1994-09-28 Heart Rhythm Technologies, Inc. Catheter for electrophysiological procedures
US5431168A (en) * 1993-08-23 1995-07-11 Cordis-Webster, Inc. Steerable open-lumen catheter
US5441483A (en) * 1992-11-16 1995-08-15 Avitall; Boaz Catheter deflection control
JPH08112245A (en) * 1994-10-18 1996-05-07 Terumo Corp Catheter tube
WO1996040344A1 (en) * 1995-06-07 1996-12-19 C.R. Bard, Inc. Bidirectional steering catheter
EP0790066A2 (en) * 1991-02-15 1997-08-20 Ingemar H. Lundquist Steerable catheter

Family Cites Families (32)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US34502A (en) * 1862-02-25 Improvement in bakers ovens
US3605725A (en) * 1968-08-07 1971-09-20 Medi Tech Inc Controlled motion devices
US3625200A (en) * 1969-08-26 1971-12-07 Us Catheter & Instr Corp Controlled curvable tip member
US4191196A (en) * 1976-06-15 1980-03-04 American Medical Systems, Inc. Profilometry method and apparatus
US4233991A (en) * 1978-12-18 1980-11-18 American Medical Systems, Inc. Urethral catheter puller
GB8503547D0 (en) * 1985-02-12 1985-03-13 British Petroleum Co Plc Nozzle
US4685457A (en) * 1986-08-29 1987-08-11 Donenfeld Roger F Endotracheal tube and method of intubation
US4753223A (en) * 1986-11-07 1988-06-28 Bremer Paul W System for controlling shape and direction of a catheter, cannula, electrode, endoscope or similar article
US4838859A (en) * 1987-05-19 1989-06-13 Steve Strassmann Steerable catheter
US5019090A (en) * 1988-09-01 1991-05-28 Corvita Corporation Radially expandable endoprosthesis and the like
US4960134A (en) * 1988-11-18 1990-10-02 Webster Wilton W Jr Steerable catheter
US4921482A (en) * 1989-01-09 1990-05-01 Hammerslag Julius G Steerable angioplasty device
US5037391A (en) * 1989-01-09 1991-08-06 Pilot Cardiovascular Systems, Inc. Steerable angioplasty device
US5108368A (en) * 1990-01-04 1992-04-28 Pilot Cardiovascular System, Inc. Steerable medical device
US4998916A (en) * 1989-01-09 1991-03-12 Hammerslag Julius G Steerable medical device
US5383923A (en) * 1990-10-20 1995-01-24 Webster Laboratories, Inc. Steerable catheter having puller wire with shape memory
US5409453A (en) * 1992-08-12 1995-04-25 Vidamed, Inc. Steerable medical probe with stylets
US5419767A (en) * 1992-01-07 1995-05-30 Thapliyal And Eggers Partners Methods and apparatus for advancing catheters through severely occluded body lumens
US5318525A (en) * 1992-04-10 1994-06-07 Medtronic Cardiorhythm Steerable electrode catheter
AU4026793A (en) * 1992-04-10 1993-11-18 Cardiorhythm Shapable handle for steerable electrode catheter
US5325845A (en) * 1992-06-08 1994-07-05 Adair Edwin Lloyd Steerable sheath for use with selected removable optical catheter
US5334145A (en) * 1992-09-16 1994-08-02 Lundquist Ingemar H Torquable catheter
US5364351A (en) * 1992-11-13 1994-11-15 Ep Technologies, Inc. Catheter steering mechanism
CA2109980A1 (en) * 1992-12-01 1994-06-02 Mir A. Imran Steerable catheter with adjustable bend location and/or radius and method
US5368564A (en) * 1992-12-23 1994-11-29 Angeion Corporation Steerable catheter
WO1994024930A1 (en) * 1993-04-28 1994-11-10 Webster Wilton W Jr Electrophysiology catheter with pre-curved tip
US5397321A (en) * 1993-07-30 1995-03-14 Ep Technologies, Inc. Variable curve electrophysiology catheter
US5492119A (en) * 1993-12-22 1996-02-20 Heart Rhythm Technologies, Inc. Catheter tip stabilizing apparatus
US5715832A (en) * 1995-02-28 1998-02-10 Boston Scientific Corporation Deflectable biopsy catheter
US5681280A (en) * 1995-05-02 1997-10-28 Heart Rhythm Technologies, Inc. Catheter control system
US5656030A (en) * 1995-05-22 1997-08-12 Boston Scientific Corporation Bidirectional steerable catheter with deflectable distal tip
US6123699A (en) * 1997-09-05 2000-09-26 Cordis Webster, Inc. Omni-directional steerable catheter

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3470876A (en) * 1966-09-28 1969-10-07 John Barchilon Dirigible catheter
EP0415553A1 (en) * 1989-07-31 1991-03-06 Kabushiki Kaisha Machida Seisakusho Bending device
EP0790066A2 (en) * 1991-02-15 1997-08-20 Ingemar H. Lundquist Steerable catheter
US5441483A (en) * 1992-11-16 1995-08-15 Avitall; Boaz Catheter deflection control
EP0616794A1 (en) * 1993-03-12 1994-09-28 Heart Rhythm Technologies, Inc. Catheter for electrophysiological procedures
US5431168A (en) * 1993-08-23 1995-07-11 Cordis-Webster, Inc. Steerable open-lumen catheter
JPH08112245A (en) * 1994-10-18 1996-05-07 Terumo Corp Catheter tube
WO1996040344A1 (en) * 1995-06-07 1996-12-19 C.R. Bard, Inc. Bidirectional steering catheter

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
PATENT ABSTRACTS OF JAPAN vol. 096, no. 009, 30 September 1996 (1996-09-30) & JP 08 112245 A (TERUMO CORP), 7 May 1996 (1996-05-07) *

Cited By (78)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7905864B2 (en) 1998-06-04 2011-03-15 Biosense Webster, Inc. Injection catheter with multi-directional delivery injection needle
US7468057B2 (en) 1998-06-04 2008-12-23 Biosense Webster, Inc. Injection catheter with controllably extendable injection needle
US8977344B2 (en) 1998-06-04 2015-03-10 Biosense Webster, Inc. Injection catheter with needle electrode
EP0980693B1 (en) * 1998-08-14 2005-01-12 Biosense Webster, Inc. Bi-directional steerable catheter
US7416547B2 (en) 1999-03-29 2008-08-26 Biosense Webster Inc. Injection catheter
EP1099453A2 (en) 1999-11-12 2001-05-16 Biosense Webster, Inc. Injection catheter
EP1251768A4 (en) * 2000-02-01 2005-08-17 David L Pruitt Multi-lumen medical device
EP1251768A1 (en) * 2000-02-01 2002-10-30 David L. Pruitt Multi-lumen medical device
US6875170B2 (en) 2000-04-21 2005-04-05 Universite Pierre Et Marie Curie Positioning, exploration, and/or intervention device, in particular in the field of endoscopy and/or mini-invasive surgery
EP1151726A1 (en) 2000-05-01 2001-11-07 Biosense Webster, Inc. Catheter with enhanced ablation electrode
EP1169972A1 (en) 2000-07-07 2002-01-09 Biosense Webster, Inc. Mapping and ablation catheter
EP2363152A1 (en) * 2000-09-06 2011-09-07 Johns Hopkins University Cardiac arrhythmia treatment methods
EP1205207A1 (en) 2000-11-09 2002-05-15 Biosense Webster, Inc. Injection catheter with controllably extendable injection needle
EP1254641A3 (en) * 2001-04-30 2004-09-01 Biosense Webster, Inc. Asymmetrical bidirectional steerable catheter
EP1254641A2 (en) * 2001-04-30 2002-11-06 Biosense Webster, Inc. Asymmetrical bidirectional steerable catheter
EP1429649A2 (en) * 2001-09-24 2004-06-23 Novoste Corporation Methods and apparatus employing ionizing radiation for treatment of cardiac arrhythmia
EP1429649A4 (en) * 2001-09-24 2008-08-20 Best Vascular Inc Methods and apparatus employing ionizing radiation for treatment of cardiac arrhythmia
US8012078B2 (en) 2001-09-24 2011-09-06 Best Vascular Methods and apparatus employing ionizing radiation for treatment of cardiac arrhythmia
EP1690510A1 (en) 2005-02-14 2006-08-16 Biosense Webster, Inc. Irrigated tip catheter and method for manufacturing therefor
EP1803481A2 (en) 2005-12-30 2007-07-04 Biosense Webster, Inc. Dual-lever bi-directional handle
US10569053B2 (en) 2005-12-30 2020-02-25 Biosense Webster, Inc. Dual-lever bi-directional handle
US11511078B2 (en) 2005-12-30 2022-11-29 Biosense Webster, Inc. Dual-lever bi-directional handle
EP1803481A3 (en) * 2005-12-30 2007-12-05 Biosense Webster, Inc. Dual-lever bi-directional handle
US9833595B2 (en) 2005-12-30 2017-12-05 Biosense Webster, Inc. Dual-lever bi-directional handle
US8021363B2 (en) 2006-05-01 2011-09-20 Ethicon Endo-Surgery, Inc. Dual-bend sphinctertome
EP1852082A1 (en) * 2006-05-01 2007-11-07 Ethicon Endo-Surgery, Inc. Dual-bending sphinctertome
US9795447B2 (en) 2008-03-27 2017-10-24 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter device cartridge
EP2195064A1 (en) * 2008-03-27 2010-06-16 St. Jude Medical, Atrial Fibrillation Robotic catheter device cartridge
US11717356B2 (en) 2008-03-27 2023-08-08 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method of automatic detection of obstructions for a robotic catheter system
WO2009120945A1 (en) 2008-03-27 2009-10-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter device cartridge
US10231788B2 (en) 2008-03-27 2019-03-19 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter system
EP2195064B1 (en) * 2008-03-27 2018-09-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter device cartridge
US10426557B2 (en) 2008-03-27 2019-10-01 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method of automatic detection of obstructions for a robotic catheter system
US11464586B2 (en) 2009-04-29 2022-10-11 Auris Health, Inc. Flexible and steerable elongate instruments with shape control and support elements
US9254123B2 (en) 2009-04-29 2016-02-09 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
US10363103B2 (en) 2009-04-29 2019-07-30 Auris Health, Inc. Flexible and steerable elongate instruments with shape control and support elements
EP3090776A1 (en) * 2009-04-29 2016-11-09 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
EP2424609A4 (en) * 2009-04-29 2012-09-19 Hansen Medical Inc Flexible and steerable elongate instruments with shape control and support elements
EP2424609A1 (en) * 2009-04-29 2012-03-07 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
US10357322B2 (en) 2009-07-22 2019-07-23 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method for controlling a remote medical device guidance system in three-dimensions using gestures
CN103079626B (en) * 2010-08-10 2015-04-22 日本来富恩株式会社 Catheter
CN103079626A (en) * 2010-08-10 2013-05-01 日本来富恩株式会社 Catheter
US10555780B2 (en) 2010-09-17 2020-02-11 Auris Health, Inc. Systems and methods for positioning an elongate member inside a body
US11213356B2 (en) 2010-09-17 2022-01-04 Auris Health, Inc. Systems and methods for positioning an elongate member inside a body
US11419518B2 (en) 2011-07-29 2022-08-23 Auris Health, Inc. Apparatus and methods for fiber integration and registration
US10667720B2 (en) 2011-07-29 2020-06-02 Auris Health, Inc. Apparatus and methods for fiber integration and registration
US10791950B2 (en) 2011-09-30 2020-10-06 Biosense Webster (Israel) Ltd. In-vivo calibration of contact force-sensing catheters using auto zero zones
EP2591819A1 (en) 2011-11-10 2013-05-15 Biosense Webster (Israel), Ltd. Medical device control handle with multiplying linear motion
EP3002029A1 (en) * 2011-11-10 2016-04-06 Biosense Webster (Israel) Ltd. Medical device control handle with multiplying linear motion
CN103099675A (en) * 2011-11-10 2013-05-15 韦伯斯特生物官能(以色列)有限公司 Medical device control handle with multiplying linear motion
CN103099675B (en) * 2011-11-10 2016-05-11 韦伯斯特生物官能(以色列)有限公司 There is the medical treatment device joystick of multiplication linear movement
AU2012247055B2 (en) * 2011-11-10 2015-06-18 Biosense Webster (Israel), Ltd. Medical device control handle with multiplying linear motion
US8460237B2 (en) 2011-11-10 2013-06-11 Biosense Webster (Israel), Ltd. Medical device control handle with multiplying linear motion
EP2803380A1 (en) * 2011-11-10 2014-11-19 Biosense Webster (Israel) Ltd Medical device control handle with multiplying linear motion
US11723636B2 (en) 2013-03-08 2023-08-15 Auris Health, Inc. Method, apparatus, and system for facilitating bending of an instrument in a surgical or medical robotic environment
US10376672B2 (en) 2013-03-15 2019-08-13 Auris Health, Inc. Catheter insertion system and method of fabrication
US11413428B2 (en) 2013-03-15 2022-08-16 Auris Health, Inc. Catheter insertion system and method of fabrication
US10405939B2 (en) 2013-10-24 2019-09-10 Auris Health, Inc. Endoscopic device with helical lumen design
US10405940B2 (en) 2013-10-24 2019-09-10 Auris Health, Inc. Endoscopic device with double-helical lumen design
US11511079B2 (en) 2014-07-01 2022-11-29 Auris Health, Inc. Apparatuses and methods for monitoring tendons of steerable catheters
US10398518B2 (en) 2014-07-01 2019-09-03 Auris Health, Inc. Articulating flexible endoscopic tool with roll capabilities
US11759605B2 (en) 2014-07-01 2023-09-19 Auris Health, Inc. Tool and method for using surgical endoscope with spiral lumens
US11350998B2 (en) 2014-07-01 2022-06-07 Auris Health, Inc. Medical instrument having translatable spool
US10493241B2 (en) 2014-07-01 2019-12-03 Auris Health, Inc. Apparatuses and methods for monitoring tendons of steerable catheters
US10814101B2 (en) 2014-07-01 2020-10-27 Auris Health, Inc. Apparatuses and methods for monitoring tendons of steerable catheters
US10792464B2 (en) 2014-07-01 2020-10-06 Auris Health, Inc. Tool and method for using surgical endoscope with spiral lumens
US11819636B2 (en) 2015-03-30 2023-11-21 Auris Health, Inc. Endoscope pull wire electrical circuit
US11701192B2 (en) 2016-08-26 2023-07-18 Auris Health, Inc. Steerable catheter with shaft load distributions
US10463439B2 (en) 2016-08-26 2019-11-05 Auris Health, Inc. Steerable catheter with shaft load distributions
US10716461B2 (en) 2017-05-17 2020-07-21 Auris Health, Inc. Exchangeable working channel
US11730351B2 (en) 2017-05-17 2023-08-22 Auris Health, Inc. Exchangeable working channel
US11109920B2 (en) 2018-03-28 2021-09-07 Auris Health, Inc. Medical instruments with variable bending stiffness profiles
US10898276B2 (en) 2018-08-07 2021-01-26 Auris Health, Inc. Combining strain-based shape sensing with catheter control
US11779400B2 (en) 2018-08-07 2023-10-10 Auris Health, Inc. Combining strain-based shape sensing with catheter control
US11179212B2 (en) 2018-09-26 2021-11-23 Auris Health, Inc. Articulating medical instruments
US11779421B2 (en) 2018-09-26 2023-10-10 Auris Health, Inc. Articulating medical instruments
US11617627B2 (en) 2019-03-29 2023-04-04 Auris Health, Inc. Systems and methods for optical strain sensing in medical instruments
US11717147B2 (en) 2019-08-15 2023-08-08 Auris Health, Inc. Medical device having multiple bending sections

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DE69827572D1 (en) 2004-12-23
EP0904796B1 (en) 2004-11-17
EP0904796A3 (en) 1999-09-15
US6123699A (en) 2000-09-26
US6500167B1 (en) 2002-12-31
JP4194691B2 (en) 2008-12-10
JPH11188102A (en) 1999-07-13
DE69827572T2 (en) 2005-12-08
US6066125A (en) 2000-05-23

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